Overview The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters.
Qualifications Certifications: Certified Inpatient Coder (CIC) – American Academy of Professional Coders (AAPC); Certified Coding Specialist – Physician-Based (CCS‑P) – American Health Information Management Association (AHIMA); Certified Coding Specialist (CCS) – AHIMA; Registered Health Information Technician (RHIT) – AHIMA; Registered Health Information Administrator (RHIA) – AHIMA; Certified Professional Coder (CPC) – AAPC; Certified Outpatient Coder (COC) – AAPC
Education: High School Diploma or G.E.D.
Work Experience: Knowledge of ICD-10-CM, CPT, and HCPC coding rules and guidelines for code application; ability to work with others collaboratively and communicate efficiently, both orally and in writing. Knowledge of medical science, anatomy and physiology required. Ability to perform computer data entry. Experience with encoders or other coding software packages preferred.
Responsibilities Accurately code all records according to the appropriate coding classification (ICD-10 and/or CPT and/or HCPCs and modifiers) system. Assignment of codes must accurately reflect the diagnoses and procedures pertinent to the patient.
Provide interdepartmental coding assistance, as needed, to determine accurate coding assignment.
Develop methodology to provide a coding process that is compliant with regulatory agencies including utilization of reference materials such as CMS publications, Coding Clinic, CPT Assistant, etc.
Facilitate optimization of revenue while maintaining compliance standards for the organization through varied venues and tasks (auditing/monitoring, training, facilitation of charges through claim scrubber system, assisting with various patient or payor related charge/account inquiries, research on various coding/billing related topics requested by internal and external sources).
Serve as an expert resource regarding CPT, HCPCS, ICD-10-CM, and other necessary coding systems, and regulatory guidelines for all internal and external parties.
Act as liaison for coding and billing staff to ensure accurate charge capture.
Report any documentation and coding improvement needs based upon review findings.
Maintain coding certification, knowledge, and skills to successfully perform job duties.
Perform provider and peer coding audits as requested.
Assist with monitoring of internal controls for coding and billing.
Facilitate external audit activities and report to appropriate administrative personnel.
Compensation and Benefits The compensation range for this position is $23.58 per hour - $39.38 per hour. This represents a good faith minimum and maximum range for the role at the time of posting. The actual compensation offered to a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.
Equal Opportunity Employer We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I‑9 to confirm work authorization. For more information: human.resources@carle.com.
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