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Evergreen Nephrology

Empowering nephrologists to transform kidney care and improve patient outcomes

Lead CDI Coder

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteSeniorTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

38 days ago

Salary

$70K - $80K / year

Seniority

Senior

High School3 yrs expEnglish

Job Description

Lead CDI Coder

Evergreen Nephrology

• Accurately code diagnoses based on documented information, ensuring compliance with regulatory requirements and that the assigned codes accurately represent the clinical information documented by the provider • Ensure documentation supports appropriate level(s) of care and severity of illness when applying ICD-10, CPT, and other relevant codes for billing and regulatory compliance • Maintain a 95% productivity rate • Communicate with physicians and other healthcare providers to clarify documentation, ensuring that diagnoses and procedures are properly documented in compliance with clinical standards • Issue queries to healthcare providers when documentation appears ambiguous, incomplete, or inconsistent, requesting clarification or additional details be added to the medical record to ensure accurate documentation • Ensure that the queries are compliant with industry standards and regulatory guidelines • Stay updated on current coding guidelines, clinical protocols, and regulatory changes, including Medicare and Medicaid guidelines on billing and coding, to support provider compliance therewith • Assist in improving the quality of clinical documentation to support various quality initiatives, such as HEDIS, CMS, and other contractual or enterprise-initiated performance metrics • Participate in performance improvement projects aimed at improving documentation practices and outcomes • Conduct audits of medical records to identify trends in documentation, both positive and negative, to help the organization improve documentation practices and provider education efforts • Provide ongoing education to clinical staff, coders, and other healthcare providers on best practices in clinical documentation, coding guidelines, and regulatory compliance • Develop training programs to address documentation deficiencies and improve overall documentation quality • Collaborate with departments such as compliance, revenue cycle, and quality management to optimize the documentation improvement process • Other duties consistent with this role, as assigned.

Job Requirements

  • High school diploma, GED, or suitable equivalent
  • 3+ years recent outpatient medical coding experience
  • Must possess one of the following coding credentials: CPC, CRC, CCS, CPMA or similar
  • Strong knowledge of ICD-10-CM, Category II and CPT coding
  • Proficiency in medical terminology, anatomy, and physiology
  • Familiarity with healthcare laws, regulations, and other applicable guidance, such as Medicare, Medicaid, HEDIS, and CMS performance measures
  • Knowledge of risk adjustment methodology and Hierarchical Condition Categories (HCC)
  • Ability to analyze complex medical records, identify documentation gaps, and determine appropriate queries
  • Strong written and verbal communication skills
  • Meticulous attention to detail that ensures a high level of accuracy in your work product
  • Ability to identify discrepancies in clinical documentation and partner with providers to resolve issues efficiently.
  • Familiarity with electronic health records (EHR), CDI software, and healthcare documentation systems is essential
  • Intermediate skills with MS Office Suite of products including Outlook and Teams
  • Able to work effectively in a primarily remote environment

Benefits

  • Paid time off starting at 4 weeks for full-time employees
  • 12 paid holidays per year
  • Medical, dental, vision and life insurance, including an HSA with employer match
  • Reimbursement for continuing medical education for eligible roles
  • A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure
  • Paid parental leave
  • A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology

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