Albany Medical Center

Role Description 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. This position is remote. - Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers, and charges applied by providers. - 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. - 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. Requirements - 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 - Frequently - Repetitive 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 Description The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. - Use a computerized encoding system to facilitate accurate coding. - Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. - Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes completely and accurately. - Query the provider for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record. - Demonstrate behavior that reflects integrity and a commitment to ethical and legal coding practices. - Utilize official coding rules and guidelines to apply the most accurate coding to represent patient services on the hospital claim. - Comply with comprehensive internal coding policies and procedures that are consistent with requirements. - Attend coding meetings and roundtable sessions. - Participate in daily huddles and LEAN problem-solving activities. - Ensure camera is on while attending Teams calls. - Assist with organizing the shared drive for the medical coding department. - Other duties as assigned by manager. Qualifications - High School Diploma/G.E.D. - required - Prior experience in hospital medical coding - preferred - Prior experience with 3M 360 and EPIC system - preferred - Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. - Excellent computer skills, navigating multiple systems at once, troubleshooting. - Must be able to work independently as position is fully remote. - Excellent written and verbal communication skills. - Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system. - Detail-oriented and efficient while maintaining productivity. - Coding certification / credential through AHIMA or AAPC and be in good standing - required - Equivalent combination of relevant education and experience may be substituted as appropriate. Requirements - 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 - Rarely - Talking - Frequently - Hearing - Frequently - Repetitive 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 Description The Senior Hospital Coder is responsible for performing detailed inpatient coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. This is a remote inpatient position. - Optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases. - Understand the hospital inpatient and CBO billing and registration systems. - Assist with educating providers, clinicians, and others by advocating proper documentation practices. - Assist in problem-solving processes and workgroups, including developing query policies. - Assist leadership in team collaboration, leading meetings, and onboarding new staff. - Communicate both verbally and in writing to physicians, clinical departments, medical coders, and management teams. - Query and/or consult as needed with the provider for clarification and additional documentation. - Provide feedback to coding staff on quality scores. - Communicate with management regarding trends or concerns about poor quality. - Schedule calls and be available for coding staff questions related to coding. - Lead a morning huddle one week each quarter in a 12-month calendar year. - Communicate to Coding Support Specialist on topics for monthly meetings. - Research new coding clinics, guidelines, and concepts and provide education to staff. - Advance coding knowledge and practice through continuing education. - Research coding forums and coding issues related to registration status. - Work with multiple software systems, including Epic, Solventum 360, Outlook, MS Teams, Word, Excel, and Citrix. - Assist with organizing the shared drive for the medical coding department. - Assist in the development and compliance of comprehensive internal coding policies and procedures. - Participate in discussions and projects to improve turnaround time for coding. - Participate in daily huddles and LEAN problem-solving activities. - Demonstrate change-leadership skills and support collaboration among coders. - Connect with coders when necessary, acting as a mentor and guide. Qualifications - High School Diploma/G.E.D. - required - Associate's Degree in Health Information Management or related program - preferred - 1-3 years experience in a leadership, supervision, or code auditing position - required - 2 or more years of experience coding ICD-10-CM/PCS coding - required - Experience with 3M 360 and EPIC - preferred - Applicants must receive a minimum score of 85% on a coding assessment. - Expert level with reading a medical record to assign ICD-10-CM, ICD-10-PCS, and assign DRG. - Highly skilled in team development, critical thinking, organization, verbal, and written communication. - Ability to work independently and effectively with a team. - Coding certification/credential through AHIMA or AAPC and be in good standing - required - RHIT / RHIA - preferred - Equivalent combination of relevant education and experience may be substituted as appropriate. Requirements - 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 - Rarely - Talking - Frequently - Hearing - Frequently - Repetitive 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

• Responsible for the strategic leadership and management of activities and services related to professional coding operations • Develops strategy and establishes efficiencies that align with the organizational goals • Oversees the coding team, developing goals and objectives, and establishing policies and procedures for team operations • Positioning the AMHS professional coding operation for financial and operational sustainability • Analyzes and establishes plans to ensure that AMHS professional coding services are progressive and effective

Title: Clin Doc Spec Location: NY-Albany time type Full time Hybrid job requisition id 69921 Job Description: Department/Unit: AMHS - Clinical Documentation Integrity Work Shift: Day (United States of America) Salary Range: $77,075.00 - $119,466.00 This is a Hybrid position so must reside in New York State. Utilizes clinical expertise to assess clinical documentation concurrently and retrospectively; contributes to improvement of the overall completeness and quality of the documentation/medical record; collaborates extensively with physicians and other health care providers so that the clinical documentation reflects accurately the complexity of patient’s care; provides ongoing education to all healthcare providers regarding the importance of accurate documentation; collaborates with the HIM and the Quality Management departments; exhibits extensive knowledge of clinical documentation requirements and DRG assignment; supports timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. Education: • Bachelor’s degree in Nursing or health related degree is required • MD, DO, MBBS or foreign educated medical graduate with advanced clinical practice experience Licensure, Certification & Registration: • Valid CDI Certification such as CDIP or CCDS preferred • Valid Coding certification such as CCA or CCS preferred • Current NYS RN license required for nurses • If foreign educated medical graduate, ECFMG certificate preferred Experience: • Advanced clinical experience with extensive knowledge of complex disease processes and broad clinical practice experience in the inpatient and outpatient settings required • CDI experience preferred • At least 5 years adult acute care practice experience • Demonstrated effective, collegial communication with physicians, other providers, staff and leadership through direct discussion and written communications Skills, Knowledge & Abilities: • Excellent interpersonal and analytical skills. • Must be able to function independently, interpret information, communicate with medical and clinical staff and both internal and external to the institution • Able to provide oral presentations both in person and virtually • Must be motivated, organized with excellent verbal, written communication skills, and conversant with adult professional learners. • Ability to work independently and as a member of a team utilizing critical thinking skills. • Demonstrated competence in data analysis and data interpretation. • Knowledge of ICD-10 codes and coding guidelines. • Ability to prioritize workflow and manage various initiatives. • Demonstrated quality improvement knowledge/skills with regard to workflow and productivity processes • Strong speaking and writing skills required • Excellent presentation skills required • Able to produce reports in Microsoft Office components, Word, Power Point, Excel, and Access data bases • Demonstrated effective facilitation skills • Good listening skills • Strong interpersonal communication skills with the ability to relate to all levels of education and organization positions Thank you for your interest in Albany Med Health System!​ Albany Med Health System is an equal opportunity employer. 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.

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $59,066.00 - $88,599.00 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities - Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. - Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines. - Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. - Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. - Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. - Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim. - Comply with comprehensive internal coding policies and procedures that are consistent with requirements. - Attends coding meetings and roundtable sessions. - Participates in daily huddles and LEAN problem-solving activities. - Focused with no distractions while working and participating in meetings. - Ensures camera on while attending Teams calls. - Assists with organizing the shared drive for the medical coding department. - Other duties as assigned by manager. Qualifications - High School Diploma/G.E.D. - required - Prior experience in hospital medical coding - preferred - Prior experience with 3M 360 and EPIC system - preferred - Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency) - Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency) - Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency) - Excellent written and verbal communication skills. (High proficiency) - Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency) - Detail-oriented and efficient while maintaining productivity. - Coding certification / 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 - Rarely - Talking - Frequently - Hearing - Frequently - Repetitive 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 Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Med Health System!​ Albany Med Health System is an equal opportunity employer. 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.

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $59,066.00 - $88,599.00 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities - Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. - Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines. - Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. - Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. - Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. - Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim. - Comply with comprehensive internal coding policies and procedures that are consistent with requirements. - Attends coding meetings and roundtable sessions. - Participates in daily huddles and LEAN problem-solving activities. - Focused with no distractions while working and participating in meetings. - Ensures camera on while attending Teams calls. - Assists with organizing the shared drive for the medical coding department. - Other duties as assigned by manager. Qualifications - High School Diploma/G.E.D. - required - Prior experience in hospital medical coding - preferred - Prior experience with 3M 360 and EPIC system - preferred - Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency) - Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency) - Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency) - Excellent written and verbal communication skills. (High proficiency) - Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency) - Detail-oriented and efficient while maintaining productivity. - Coding certification / 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 - Rarely - Talking - Frequently - Hearing - Frequently - Repetitive 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 Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Med Health System!​ Albany Med Health System is an equal opportunity employer. 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.

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities - Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. - Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines. - Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. - Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. - Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. - Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim. - Comply with comprehensive internal coding policies and procedures that are consistent with requirements. - Attends coding meetings and roundtable sessions. - Participates in daily huddles and LEAN problem-solving activities. - Focused with no distractions while working and participating in meetings. - Ensures camera on while attending Teams calls. - Assists with organizing the shared drive for the medical coding department. - Other duties as assigned by manager. Qualifications - High School Diploma/G.E.D. - required - Prior experience in hospital medical coding - preferred - Prior experience with 3M 360 and EPIC system - preferred - Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency) - Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency) - Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency) - Excellent written and verbal communication skills. (High proficiency) - Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency) - Detail-oriented and efficient while maintaining productivity. - Coding certification / 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 - Rarely - Talking - Frequently - Hearing - Frequently - Repetitive 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 Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Med Health System!​ Albany Med Health System is an equal opportunity employer. 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.

Department/Unit: Health Information Management Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant 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 compliant 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 - Frequently - Repetitive 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 Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Med Health System!​ Albany Med Health System is an equal opportunity employer. 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.

Review denied claims and prepare appeal letters using clinical evidence. Collaborate with clinical staff to enhance documentation and reduce denials, while tracking denial data to recommend process improvements and ensure compliance with regulations.