Outpatient/Professional Vascular Coder - REMOTE

Centra is seeking a detail-oriented and motivated Vascular Outpatient Coder to join our dynamic healthcare team. In this vital role, you will be responsible for accurately translating clinical documentation into precise medical codes to ensure proper billing, reimbursement, and compliance. Your expertise will support our commitment to delivering exceptional vascular outpatient care while maintaining the highest standards of medical coding integrity. This position offers an exciting opportunity to contribute to a fast-paced environment where your skills directly impact patient outcomes and organizational success. This is a fully remote - Monday-Friday, day shift role.

The Outpatient Specialty Medical Coder is responsible for coding outpatient records, Facility, and/or Professional, for the purpose of reimbursement in compliance with federal, state, and regulatory agencies’ guidelines using the most current taxonomic and classification systems. Performs coding, charge entry, and charge review including but not limited to, reviewing clinical documentation, appending modifiers and/or correcting edits. The Outpatient Specialty Medical Coder I will be responsible for coding the following services: Non Centra Medical Group (CMG) Vascular, Endoscopy, Orthopedic Surgery, Gynecologic Surgery, Surgical Observation, General Surgery, Plastic Surgery, Neurosurgery, Urology, Bariatric Surgery, and Pain Management.

Reviews clinical documentation and assigns appropriate outpatient facility and/or professional codes, reviews/posts charges for the purpose of reimbursement, research, and compliance in accordance with International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), Healthcare Common Procedures Coding System (HCPCS_ and Current Procedure Terminology (CPT) coding guidelines. 

Accurately extracts clinical information from records according to established requirements using abstracting software. 

Interprets coding rules and general policies in addition to determining appropriate conclusions.

Comply with all federal, local, and other legal requirements as they relate to medical coding practices.

Submit coding queries, as needed, per coding guidelines and Centra policy and participate in physician education, as needed.

Maintain worklists for Professional coding for reconciliation of charges and reporting to CMG office staff and providers.

Resolves National Correct Coding Initiative (NCCI) and medical necessity edits in the 3M Coding and Reimbursement System to ensure clean claim submission. 

Reviews Outpatient Specialty claims in assigned work queues in Cerner Revenue Cycle.exe. Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including nursing notes, provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges and coding. Determines appropriate action needed to resolve coding edits/issues and ensure clean claim submission.

Research and resolve charge review, claim edit, and denials; asks assistance from higher level staff on more complex issues.

Requirements:

Coding certification: Certified Professional Coding Certification (CPC) (CPC-H), (CPC-P); or Certified Coding Specialist (CCS) or other related American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) certification.

Education: Completion of coding training program to include anatomy & physiology, medical terminology, basic ICD-10 diagnostic, and basic CPT® procedural coding.

Experience: Minimum 5 years of facility and/or professional Vascular coding experience.