Department/Unit
Health Information Management
Work Shift
Day (United States of America)
Salary Range
$55,895.80 - $83,843.71
Job Summary
The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote.
Essential Duties and Responsibilities
Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines.
Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes.
Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role.
Ensure established productivity and quality standards are met.
Review denials, research and respond appropriately and timely.
Perform audits as determined by management.
Assist with all levels of application testing for identified coding workflows as needed.
Attend and contribute to all PCO staff meetings, department meetings and all other meetings assigned.
Assume responsibility for professional development by participating in webinars, workshops, and conferences when appropriate.
Ability to work well with people from different disciplines with varying degrees of business and technical expertise.
Remain knowledgeable of all insurance products (including Managed care, Medicaid and Medicare), policies and procedures as well as State and Federal mandates and legislation in relation to coding and documentation.
Interact with providers and their staff to support accuracy and specificity in documentation and procedural and diagnostic coding.
All other duties as assigned.
Qualifications
High School Diploma/G.E.D. - required
1-3 years Experience in provider professional fee coding - preferred
Working knowledge and experience with provider professional fee coding and charge processing. Computer experience, windows environment with proficiency in Microsoft Word and Excel is required. Excellent verbal and written communication skills. (High proficiency)
CPC, CCA, CCS, COC, RHIT, RHIA or other coding credential through AHIMA or AAPC and be in good standing. - required
Equivalent combination of relevant education and experience may be substituted as appropriate.
Physical Demands
Standing - Occasionally
Walking - Occasionally
Sitting - Constantly
Lifting - Rarely
Carrying - Rarely
Pushing - Rarely
Pulling - Rarely
Climbing - Rarely
Balancing - Rarely
Stooping - Rarely
Kneeling - Rarely
Crouching - Rarely
Crawling - Rarely
Reaching - Rarely
Handling - Occasionally
Grasping - Occasionally
Feeling - Frequently
Talking - Frequently
Hearing - FrequentlyRepetitive Motions - Frequently
Eye/Hand/Foot Coordination - Frequently
Working Conditions
Extreme cold - Rarely
Extreme heat - Rarely
Humidity - Rarely
Wet - Rarely
Noise - Occasionally
Hazards - Rarely
Temperature Change - Rarely
Atmospheric Conditions - Rarely
Vibration - Rarely
Role
This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a need to know and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Albany Med Health System is an equal opportunity employer.
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