Overview Description: Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principal and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties.
Responsibilities Performs coding and charge entry of surgical services dropped in Epic with a generic placeholder or PBSUR.
Detailed in code selections. Maintains accuracy of 95% or greater.
Performs accurate resolution of assigned hospital-based and surgical charge review errors and claim edits in Epic, keeping WQ aging Reviews documentation in Epic or other sources to appropriately determine ICD-10, CPT, HCPCS, and modifier assignment.
Researches all information needed to complete coding process.
Follows daily, weekly & monthly productivity requirements.
Resolves coding discrepancies related to coding and revenue capture.
Participates in the liaison process between the Centralized Coding, Providers, Managers, and Leadership.
Maintains coding credentials (CPC, CCS) current at all times.
Serves as a resource for providers, managers, peers.
Performs other related duties as assigned.
Qualifications Minimum - Associates Degree in allied health related field, including classes in medical terminology, anatomy and physiology; or two years of increasingly responsible medical records experience with exposure to medical terminology, anatomy, physiology, and coding; or an equivalent combination of education and experience.
Minimum – Certified Coding Specialist or Certified Professional Coder credential.
One – three (1-3) years of professional coding experience, with multiple surgical specialties preferred.
Preferred - prior experience in coding for neurosurgery, thoracic surgery, and/or gynecologic oncology procedures.
Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations.
Solid understanding of ICD-9 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, HMO and commercial insurance plans.
Ability to maintain accurate records and to prioritize and organize work effectively.
Ability to exercise independent judgment as appropriate within standard practices and procedures.
Hours, Schedule & Location Remote position
Day shift hours
Benefits Competitive compensation, DailyPay
Benefits effective Day One — No waiting periods.
Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term Disability
Retirement savings plan with employer match and contributions
Colleague Referral Program to earn cash and prizes
Unlimited career growth opportunities with one of the largest Catholic healthcare organizations in the country
Tuition Reimbursement
What the Professional Surgical Coder will do: Responsibilities include coding and charge entry duties as described above and supporting the charge capture process within the SMHC system.
Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
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