• The Certified Medical Coder is responsible for accurate, compliant, and timely coding of professional and facility pain management services • Assign accurate CPT, HCPCS, and ICD-10 codes for all services performed at BHC facilities • Apply appropriate modifier usage based on payer and service requirements • Ensure documentation supports medical necessity, procedural complexity, and level of services • Apply correct diagnosis sequencing and body-part specificity required for WC claims • Support WC-specific documentation requirements, including injury dates, causality, and treating physician narratives • Collaborate with billing teams to ensure correct claim formats, attachments, and WC payer rules are met • Ensure coding compliance with CMS, AMA, NCCI, and OIG guidelines • Participate in internal and external coding audits, implement corrective actions as needed • Identify coding trends that impact denials, underpayments, or compliance risk • Provide feedback and education to provider to improve documentation and coding accuracy

Role Description BJC is hiring for an Inpatient Coder I. This is a remote position. Must have one of the following certifications: CCS or CCA or RHIA or RHIT. The Inpatient Coder I assigns diagnosis and procedure codes for inpatient encounters, while adhering to all regulatory guidelines. Responsibilities - Accurately abstracts data elements as required. - Stays current of all changes in coding conventions, regulatory guidelines, code updates and BJC coding guidance. - Thoroughly reviews and analyzes patient encounters for compliant coding. Queries provider for clarification or additional information as required. - Accurately assigns codes in a timely manner. Interprets, assesses and evaluates provider documentation for appropriate DRG assignment. - Effectively collaborates with leadership, colleagues and customers (CDI, HIM Operations, and other departments) as appropriate to ensure the integrity of the medical record and coding compliance. Qualifications - High School Diploma or GED - Cert/Lic in Area of Expertise: CCS or CCA or RHIA or RHIT Requirements - No Experience - No Supervisor Experience Preferred Requirements - 2-5 years of experience Benefits - Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date - Disability insurance* paid for by BJC - Annual 4% BJC Automatic Retirement Contribution - 401(k) plan with BJC match - Tuition Assistance available on first day - BJC Institute for Learning and Development - Health Care and Dependent Care Flexible Spending Accounts - Paid Time Off benefit combines vacation, sick days, holidays and personal time - Adoption assistance *Not all benefits apply to all jobs

Role Description As a Remote Billing Specialist at Community Health Systems (CHS) - Shared Services Center, you’ll play a vital role in quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. The Remote Medical Billing Specialist is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring accuracy, compliance, and timely reimbursement. This role utilizes electronic claims management systems to review, correct, and resolve billing errors, denials, and rejections. The Billing Specialist I collaborates with internal teams, facility liaisons, and payers to ensure clean claim submission and adherence to federal, state, and payer-specific regulations. - Processes and submits primary and secondary insurance claims accurately and in a timely manner, ensuring compliance with payer guidelines and regulatory requirements. - Reviews and resolves claim errors, rejections, and denials, making necessary corrections and resubmitting claims as needed. - Demonstrates working knowledge of billing forms, including UB-04, CMS-1500, or state-specific billing forms, ensuring claims are submitted with the appropriate documentation. - Audits claims for accuracy, checking for duplicate charges, overlapped accounts, and missing information before submission. - Investigates and processes rebill requests, verifying claim accuracy and making necessary updates per facility or coding liaison direction. - Maintains knowledge of billing regulations, payer policies, and electronic submission guidelines, staying up to date with federal, state, and local billing requirements. - Utilizes electronic billing systems to analyze, research, and transmit claims, ensuring proper documentation of actions taken in the collection system. - Monitors and reports charging or edit trends, collaborating with internal teams (such as coding, patient access, and ancillary departments) to improve billing accuracy. - Performs daily balancing tasks using SSI and other billing systems, escalating unresolved issues or billing delays to the Billing Services Manager. - Communicates professionally with payers, facility representatives, and internal teams, ensuring efficient issue resolution and proper follow-up on outstanding claims. - Performs other duties as assigned. - Complies with all policies and standards. Qualifications - H.S. Diploma or GED required - Associate Degree in Business, Healthcare Administration, Medical Billing, or a related field preferred - 0-1 years of experience in medical billing, insurance claims processing, or revenue cycle operations required - 1-3 years of billing experience in a medical facility, ambulatory surgery facility, or acute-care preferred - Experience with hospital or physician billing, including knowledge of payer policies and electronic claims systems preferred Requirements - Basic understanding of insurance claim processing, medical billing, and reimbursement guidelines. - Familiarity with billing software, electronic claims management systems (e.g., SSI, Pulse/DAR), and eligibility tools. - Knowledge of CMS, Medicaid, Medicare, and commercial insurance billing regulations. - Ability to analyze and resolve claim errors, denials, and rejections efficiently. - Strong attention to detail, organizational skills, and ability to meet deadlines. - Proficiency in Microsoft Office Suite (Excel, Outlook, Word) and electronic health record (EHR) systems. - Excellent communication and problem-solving skills, with the ability to interact professionally with internal teams and external payers. Benefits - Paid Time Off (PTO) - Comprehensive Health Benefits - Medical, Dental & Vision - 401k with company match - Tuition reimbursement Company Description Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers. This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.

• Ability to comprehend medical record documentation to accurately assign codes for both concurrent and discharged accounts across multiple specialties. • Meets minimum requirements for production and quality monthly. • Requires a working knowledge of code sequencing for grouper-related payers with attention to detail to avoid rework and waste with charge capture assessment component. • Requires understanding and application of M.E.A.T. criteria (i.e., monitoring, evaluation, assessment, treatment) using ICD 10 CM transaction data set to capture diagnoses. • Analyzes high-risk encounters for accurate and/or missing charges gaps prior to encounter completion (i.e., missing charges from anesthesia, surgery) when manual charge capture occurs. • Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with un-clear, or un-substantiated care rendered. (i.e., varying modifier assignment for EAPG vs. Non-EAPG payer specificity) • Requires excellent coding knowledge of ICD 10 CM, CPT 4, and modifier application, with expectations to maintain certification (i.e., CCS, CPC, RHIT, or RHIA) and apply ICD 10 CM Coding Guidelines specific to both inpatient and outpatient encounters. • Facilitate modifications to clinical documentation through query interaction to ensure that the information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC), and risk adjustment factors (RAF). • Demonstrates an excellent working knowledge of hospital information systems to retrieve data specific information (i.e., order diagnosis, patient type) within a complicated filing schema including non-hospital data (i.e., Media Tab, Office Visits etc)