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Evaluation/Management Certified Coder | Usa

Advantum Health Logo
Advantum Health Logo
2+ years
Not Disclosed
10 Nov. 13, 2024
Job Description
Job Type: Full Time Remote Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Certified Medical Coder – Revenue Cycle Management

Job Summary:
The Certified Medical Coder is responsible for ensuring accurate coding of all visits and surgeries, supporting ongoing Revenue Cycle Performance/Management, and customer satisfaction. The Coder will act as a resource for clients and the accounts receivable team, particularly for coding-related denials, and will support the education and training of providers and staff in coding and documentation practices.

Qualifications:

  • CPC Certification through AAPC or AHIMA (Required)
  • In-depth knowledge of clinical workflow
  • Expert in Microsoft Office products (Word, Excel, PowerPoint)
  • Ability to perform production-level coding
  • 3+ years of specialty-specific coding experience
  • Training experience preferred
  • Expert knowledge of CCI edits
  • Revenue Cycle Management (RCM) experience (Required)
  • Denial management and appeals experience (Preferred)
  • Strong verbal and written communication skills
  • Ability to pass medical coding assessment
  • COSP (Certified Outpatient Coder) preferred

Responsibilities:

  • Perform medical record reviews for CPT and ICD-10 coding accuracy
  • Train providers and coding staff on charge capture platforms
  • Work with the Education Supervisor on system updates and ongoing provider/staff training
  • Assist in creating and maintaining ICD-10 CM, CPT/HCPCS coding rules and pick lists for providers
  • Educate providers and staff on key revenue cycle topics, including ICD-10, CPT/HCPCS, E/M coding, documentation, billing policies, and compliance
  • Analyze coded data to ensure documentation accuracy
  • Provide re-education for providers when documentation is inaccurate
  • Educate providers on correct documentation per CMS guidelines to ensure appropriate billing
  • Conduct concurrent coding reviews for new hires and coding staff
  • Provide timely feedback to management on coding issues
  • Assist in developing training and educational materials to address documentation and coding deficiencies
  • Coordinate new hire education and training schedules
  • Interact with providers to resolve conflicting documentation or clarify through the query process
  • Review platform upgrades and update departmental documentation as necessary
  • Report system issues and assist with resolving training workflow complexities
  • Stay current on coding updates and communicate changes to providers and coders
  • Work with management to identify denials and develop education to reduce future claim rejections
  • Understand and apply Medicare billing rules (LCD/NCD/CCI)
  • Advanced proficiency in MS Excel, Word, and PowerPoint
  • Ensure compliance with HIPAA regulations in handling Protected Health Information (PHI)
  • Perform other duties as assigned by management

Work Environment:

  • Office-based with potential for remote work