Rochester Regional Health logo
Rochester Regional Health

For All You Are, We're Here for It.

Coder – Inpatient

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteMid LevelTeam 10,001+H1B No SponsorCompany SiteLinkedIn

Location

New York

Posted

25 days ago

Salary

$22 - $32 / hour

Seniority

Mid Level

Associate Degree2 yrs expEnglish

Job Description

Coder – Inpatient

Rochester Regional Health

• Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for billing, internal and external reporting, research, and regulatory compliance. • Demonstrate knowledge of reimbursement methodologies and apply these to assigned charts to optimize reimbursement and/or resolve regulatory edits. • Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors. • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines, and keeps abreast of coding changes and interpretation of codes. • Complies with RRH & HIM department policies & procedures • Perform detailed review of Inpatient record documentation to identify & assign diagnosis & procedure codes using ICD-10-CM and ICD-10-PCS. • Meets established departmental productivity guidelines with 95% accuracy on a consistent basis. • Utilizes Care Connect, UDS and Clintegrity systems proficiently to obtain ICD10 codes and DRG assignment. • Formulates compliant Physician Coding Queries when documentation is inadequate, ambiguous or unclear for coding purposes • Enters and/or updates data accurately including Present on Admission (POA) indicators, Point of Origin, Discharge Disposition and other identified data. • Manages problematic workflow edits and other technical issues to ensure timely resolution specific to coding A/R days • Corrects failed claim errors to billing edits, accounts misclassified and/or other errors identified through various auditing processes in a timely manner. • Attends RGHS, HIM Department and Coding Team meetings and training sessions as required. • Ensure timely reporting for external regulations • Completes other duties as assigned by HIM leadership. • Provide assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process.

Job Requirements

  • One of the following certifications is required: Applicable advance coding certification credential includes: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder Hospital Based (CPC-H), Certified Medical Coder (CMC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder Apprentice CPC-A, or a specialty coding certification.
  • Candidate with Associate degree from the and accredited American Health Information Management Associates (AHIMA) are required to sit for the Registered Health Information Technician (RHIT) exam within 1 year of hire
  • At least 2 years of progressive coding experience in a hospital or multi-specialty physician practice setting preferred.
  • For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification required within 16 months of hire. Grandfather Clause:
  • If hired on or before September 30, 2018, 2 years of relevant work experience and one of the following coding certification credentials: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder - Hospital Based (CPC-H), Certified Medical Coder (CMC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or a specialty coding certification and Associate’s degree in Health Information Management are required.

Related Categories

Related Job Pages

More Medical Billing and Coding Jobs

athenahealth logo

Senior Medical Coding Automation Associate

athenahealth

We provide network-enabled services, mobile apps, and data-driven insights to hospitals and medical organizations.

Full TimeRemoteTeam 5,001-10,000Since 1997H1B Sponsor

• Analyze operational and workflow data to identify inefficiencies, root causes, and opportunities for process improvement within the Medical Coding Automation product. • Design and recommend scalable solutions that prioritize automation, AI-enabled workflows, and operational efficiency over manual processes. • Collaborate cross-functionally with Product, Operations, Commercial, and R&D teams to support implementation of workflow enhancements. • Create and maintain project plans, presentations, stakeholder communications, and performance metrics to support transparency and execution. • Ensure adherence to medical coding standards, compliance guidelines, and coding quality expectations across workflows and operational processes.

Kansas + 3 moreAll locations: Kansas | Maine | Massachusetts | Michigan
$77K - $131K / year

Coding Specialist

IES - Integrative Emergency Services

IES, which stands for Integrative Emergency Services, delivers specialized healthcare solutions in emergency medicine, driven by a commitment to physician-led c

Coding Specialist - Surgical Services - Hybrid Location: Dallas, TX Full-time Hybrid Department: Revenue Cycle Management Job Description: Integrative Emergency Services, LLC (“IES”) is seeking a Coding Specialist with emphasis on surgical services. The Coding Specialist is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA/NTCC/TSN). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. The Coding Specialist supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects Work will be based in a Hybrid format at the corporate office in North Dallas, TX, 75244. IES is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting patients, employees, clients, providers, and physicians in pursuit of the highest quality health care. ESSENTIAL DUTIES AND RESPONSIBILITIES: The responsibilities listed here represent the majority of the role but are not all-inclusive; other duties may be assigned. - Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services based on thorough medical record review. - Evaluate medical records for proper code assignment, completeness, accuracy, and support of medical necessity. - Ensure coding compliance with CMS, commercial payer, and regulatory guidelines. - Identify and address undercoding, overcoding, modifier misuse, and unbundling issues. - Apply appropriate modifiers and ensure correct provider, place of service, and payer selection. - Conduct claim review to support clean claim submission and reduce denials. - Audit coding accuracy through ad hoc reports, focused reviews, and special projects. - Analyze coding-related denials and recommend corrective actions. - Review payer policies and stay current on annual coding updates and regulatory changes. - Collaborate with providers and operational leadership to clarify documentation and improve coding specificity. - Maintain productivity and quality benchmarks established by the department. - Serve as a subject matter resource for surgical coding guidance within assigned service lines. QUALIFICATIONS Knowledge, Skills, Abilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. - High-level knowledge of general surgery-related medical terminology, anatomy, and pathophysiology. - Strong understanding of CPT procedure coding, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis coding. - Knowledge of coding in surgical practices, ambulatory surgery centers, and hospital settings. - Ability to evaluate documentation for medical necessity and coding compliance. - Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines. - Ability to audit reports, conduct focused reviews, and participate in special projects. - Advanced analytical and problem-solving skills. - High attention to detail and accuracy. - Proficiency with EHR systems, practice management systems, and claim scrubber tools. - Strong written and verbal communication skills. - Ability to manage multiple priorities and meet deadlines. - Proficiency in Microsoft Office applications. - Ability to maintain confidentiality and exercise professional discretion. Education / Experience: Include minimum education, technical training, and/or experience preferred to perform the job. Required: - High school diploma or equivalent. - Minimum five (5) years of professional medical coding experience. - Strong surgical coding experience required. - Active coding certification through: American Academy of Professional Coders (AAPC) (ie. CPC), or American Health Information Management Association (AHIMA) (ie. CCS-P). Preferred: - Certified Professional Medical Auditor (CPMA) through AAPC. - Experience conducting internal coding audits. - Experience with CMS Part B and commercial payer reimbursement methodologies.​​​​​​​ PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. - Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus - While performing the duties of this job, the employee is regularly required to talk and hear - Frequently required to stand, walk, sit, use hands to feel, and reach with hands and arms. - Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to remaining seated for periods of time to perform computer-based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.) - Occasionally lift and/or move up to 20-25 pounds - Fine hand manipulation (keyboarding) WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job - Office environment, Hybrid schedule after initial training period - 4835 Lyndon B Johnson Fwy, Dallas, TX 75244 - Monday/Friday remote - Tuesday-Thursday in office 8am-5pm - The noise level in the work environment is usually low TRAVEL: - Some travel, including overnight and local, may be required as business needs dictate. ADA & Reasonable Accommodation Statement: IES is committed to providing equal employment opportunities to qualified individuals with disabilities. In accordance with the Americans with Disabilities Act (ADA), reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. If you require accommodation during the application or employment process, please contact [email protected]. The company is committed to creating a diverse, inclusive, and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age, race, religion, nationality, sexual orientation, gender identity or expression, disability, or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds, experiences, and abilities and believe that the unique experiences of our team drive our success.

Texas
Helpware logo

Senior Team Lead

Helpware

Amazing Customer Experiences. Together.

Full TimeRemoteTeam 1,001-5,000Since 2015H1B No Sponsor

Role Description Accomplishes all of the roles and responsibilities of a Team Leader. Acts as the default Operations leader during the absence of the Operations Manager around the attainment of client KPI, goals and targets. Handles complex and specialized functions and/or teams. Prime program initiatives to drive performance. Regularly interfaces with clients and client representatives on activities and initiatives aimed at increasing performance and resolution of customer issues and client concerns. Primary Responsibilities - Accomplishes all of the roles and responsibilities of a Team Leader, including but not limited to, leading and managing a team of CSR's in the optimal execution of call center operations activities ensuring that each team member meets/exceeds their goals and metrics on a daily, weekly, and monthly basis. Conducts Performance Management activities, supports CSR's/TSR's on their calls, handles escalations, prepares reports and works with other team members for team and program initiatives. - Act as operations prime in the absence of Operations Managers related to management of day-to-day operations, including but not limited to, stakeholder management to facilitate issue resolution and making certain that client KPIs, goals, and targets are met. - Act as a liaison for both internal and external groups for program initiatives. Help create, launch and drive critical account initiatives and programs. - Be a mentor to other Team Leaders; Act as a catalyst for Peer-to-Peer Development. - Support complex and/or multiple products/LOB's/queues and/or manage and/or support resolution/escalation/coach teams and other specialized functions. - Coordinates with Workforce for net staffing requirements and scheduling of agents given leaves, absences, and attrition. Requests for overtime or 6th day work in order to meet service metrics by efficiently handling the forecast and/or spikes in call volumes. - Ensures that all Company and/or Client updates are cascaded to all individuals in the program by conducting regular meetings with Team Leads. Disseminates information in a timely manner, taking into consideration information sensitivity and confidentiality. - Liaisons with Top Management and the Client regarding the program's performance. Analyzes the necessary information (i.e. top and bottom performing teams/agents) and translates this to tangible and relevant data on program performance. - Facilitate on-boarding of new team members including Operations Orientation. Qualifications - 1-2 years call center experience as a team leader or at least six months (6) experience within TIP as a Team Leader, specializing in Customer Care and/or Marketing and Sales and/or Technical support operations. - Working knowledge of call center operations and organization required. - Prior knowledge of client-specifics (i.e. nature of account, metrics, client applications, etc…) preferred. - Proficiency with MS Office applications (i.e. MS Word, Excel, PowerPoint, etc...) and other call center-specific software/systems (i.e. CMS/IEX, NICE, VERINT, etc.). - Supervisory and people-management skills. - Project management skills. - Excellent oral and written English communication skills with professional communication skills both verbal and written business correspondence; planning, organizing and coordination skills; Adaptive to changing work schedules and working hours. - Active listening skills. - Operates with minimal supervision. - Customer orientation. - Time Management and Multitasking skills. Detail-oriented, Analytical, Problem-Solving and Decision-Making skills. - Presentation Skills.

United States
Job Closed
Pyramid Healthcare logo

Medical Billing Specialist

Pyramid Healthcare

Pyramid Healthcare, Inc. is proud of its diverse workforce and is an Equal Opportunity Employer.

Full TimeRemoteTeam 1,001-5,000H1B No Sponsor

• Ability to time manage, pull reporting, and maintain consistent AR work in a remote setting. • Position reviews charge data entry for accuracy to bill clean claims and works with other internal department to troubleshoot and resolve outstanding service and claims errors. • Performs daily compressive follow up on billed claims for rejections, denials, payment, rebilling, and reprocessing to ensure timely and accurate payments from contracted and non-contracted insurance payers. • Research and resolve incorrect payments following account to final compliant reconciliation and perform appropriate adjustments to accounts where relevant in post payment review. • Answer patient inquiries by phone regarding outstanding account balances and insurance guidelines. • Updates and maintain patient demographics and other information as needed in the EMR to ensure full account accuracy while maintaining strictest confidentiality adhering to all HIPAA guidelines. • Work routine correspondence; performs in office functions as necessary and is available to the supervisor to perform other duties as assigned.

United States
Job Closed