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Coder III
Location
United States
Posted
2 days ago
Salary
$29 - $43 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Coder III
American Addiction Centers
Role Description This role will have all responsibilities of coding assistant, coder I and II plus the following: - Assist with special projects as requested. - Assist with training other coders as requested. - Monitor and respond to accounts in the charge router, charge router messages, CRMs, Compliance and Integrity review requests. - Adhere to organizational and internal department policies and procedures to ensure efficient work processes. - Review complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals, and hospitals to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. - Assign and ensure correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. - Serve as subject matter expert in your assigned specialty and actively participate in the Coding meetings as a problem solver. - Expertise in query guidelines and coding standards. - Follow up and obtain clarification of inaccurate documentation as appropriate. - Maintain continuing education by attending webinars, reviewing updated CPT assistant guidelines, and updated coding clinics. - Knowledgeable in researching coding-related topics and issues. - Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines. - Practice ethical judgment in assigning and sequencing codes for proper insurance reimbursement. - Maintain the confidentiality of patient records. - Report any perceived non-compliant practices to the coding leader or compliance officer. - Meet and exceed departmental quality (95% or more) and productivity standards (100%). - Achieve productivity expectations to support discharged not final billed (DNFB). - Perform any other assigned duties since the duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. - Assist in the production of annual edit review based on CPT, ICD, and HCPCS changes as well as assist in the development of edits based on publications and society updates. - Answer and prioritize correspondence at all levels e.g., coding assistants, coders, leads, supervisors, and managers. Qualifications - Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC) or American Health Information Management Association (AHIMA). - Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge). - Typically requires 5 years of experience in professional coding that includes experiences in professional revenue cycle processes and health information workflows. Requirements - Proficient in Microsoft Office, Word, Excel, and PowerPoint. - Advanced knowledge and understanding of anatomy, physiology, medical terminology, pathophysiology, and is able to apply these sciences to accurately assign codes to cases including surgical cases. - Demonstrates knowledge of National Council on Compensation Insurance, Inc (NCCI) edits, and local and national coverage decisions. - Expert knowledge and experience in ICD-10-CM, CPT, and 3M Encoder. - Expert knowledge and experience in ICD-10-CM and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Payment Classifications (APC). - Advanced knowledge of pharmacology indications for drug usage and related adverse reactions. - Expert knowledge of coding workflow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems. - Excellent communication and reading comprehension skills. - Demonstrated analytical aptitude, with a high attention to detail and accuracy. - Experienced with remote workforce operations required. - Strong sense of ethics. Benefits - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training. - Premium pay such as shift, on call, and more based on a teammate's job. - Incentive pay for select positions. - Opportunity for annual increases based on performance. - Paid Time Off programs. - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability. - Flexible Spending Accounts for eligible health care and dependent care expenses. - Family benefits such as adoption assistance and paid parental leave. - Defined contribution retirement plans with employer match and other financial wellness programs. - Educational Assistance Program.
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