Remote Multispecialty Pro Fee Coder Location: Remote (Remote Office Santa Fe, NM 87501)
Compensation: Pay Range: Minimum Offer $24.27, Maximum Offer $41.33
Employment Type: Full time
Summary Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote Multispecialty Pro Fee Coder to join our team.
Responsibilities Implement and ensure compliance with enterprise‑wide and department coding policies and external regulatory coding rules.
Perform and manage on‑site internal audits or reviews to assess compliance/quality monitoring, serving as a resource on documentation, coding, billing, and compliance questions.
Develop and present educational programs, tools, and compliance projects for PHS/PMG departments.
Support enterprise‑wide corrective action plans by auditing and training coding, audit, physician, and clinician personnel identified as low performers.
Review denied and appealed claims, take appropriate action to ensure accurate payment, and coordinate the process with affected payers.
Research and interpret regulatory agency regulations.
Act as liaison to Management, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and ancillary departments for coding, auditing, compliance, and training issues.
Maintain accurate, complete, and timely documentation in electronic or hard copy form.
Adapt to changing work priorities and schedules.
Maintain up‑to‑date technical knowledge of legal and regulatory information across relevant jurisdictions, including ICD‑9, ICD‑10, CPT‑4, HCPCS, and APC updates.
Research coding, billing, and charging compliance issues, recommend and implement corrective action plans.
Identify risks, develop, and follow up on action plans, uncover lost revenue opportunities, and address overpayments due to coding or documentation errors.
Assist in creating the CDQA Annual Audit Work‑plan using OIG, Medicare and Medicaid regulations, RAC, and other audit agency focuses.
Exercise independent judgment in determining the reliability of data reviewed and recommend changes to improve compliance.
Stay informed on the business climate of the healthcare industry.
Respond to daily inquiries and requests regarding coding and auditing issues, performing ad‑hoc analysis for all PHS management.
Qualifications High school diploma or GED required.
At least one of the following credentials: RHIT, RHIA, CPC, CCS.
Minimum of three (3) years experience in coding and/or auditing.
Audit experience preferred.
Excellent written and verbal communication skills.
Detail and results oriented.
Ability to work independently and make autonomous decisions.
Knowledge of medical terminology, ICD‑9, CPT‑4, and HCPCS.
Proficient understanding of Medicare, Medicaid, and other third‑party payer documentation, coding and billing regulations for relevant service lines.
Strong organizational and planning skills with ability to prioritize multiple tasks accurately.
Computer skills: Microsoft Word, PowerPoint, Excel, internet research and resource applications.
Ability to convey complex regulatory information in layman’s terms to all management levels.
Integrity, honesty, and ability to inspire and motivate others.
Benefits Comprehensive benefits package including medical, dental, vision, short‑term and long‑term disability, group term life insurance, and optional voluntary benefits.
Employee Wellness rewards program offering gift cards and more for participating in wellness activities such as challenges, webinars, and preventive screenings.
Equal Opportunity Employer AA/EOE/VET/DISABLED.
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