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 Registered Health Information Technician (RHIT) – American Health Information Management Association (AHIMA) Registered Health Information Administrator (RHIA) – American Health Information Management Association (AHIMA) Certified Professional Coder (CPC) – American Academy of Professional Coders (AAPC) Certified Outpatient Coder (COC) – American Academy of Professional Coders (AAPC) 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) – American Health Information Management Association (AHIMA) Responsibilities Responsible for accurately coding all records according to the appropriate coding classification (ICD-10 and/or CPT and/or HCPCs and modifiers) system, ensuring codes accurately reflect the diagnoses and procedures pertinent to the patient. Provides interdepartmental coding assistance, as needed, to determine accurate coding assignment. Develops methodology to provide a coding process that is compliant with regulatory agencies, utilizing reference materials such as CMS publications, Coding Clinic, and CPT Assistant. Facilitates optimization of revenue while maintaining compliance standards through auditing, training, charge facilitation via the claim scrubber system, and assisting with patient or payer related charge/account inquiries. Serves as an expert resource regarding CPT, HCPCS, ICD-10-CM, and all other necessary coding systems, and regulatory guidelines for all internal and external parties. Acts as liaison for coding and billing staff to ensure accurate charge capture. Reports documentation and coding improvement needs based on review findings. Maintains coding certification, knowledge, and skills to successfully perform job duties. Performs provider and peer coding audits as requested. Assists with monitoring of internal controls for coding and billing. Facilitates external audit activities and reports such activities to the appropriate administrative personnel. 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. Salary Range 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 by Carle Health. 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. #J-18808-Ljbffr