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CommonSpirit Health is a nonprofit organization that is on a mission to improve people’s health while making “the healing presence of God known.” The orga
Value Based Coder II
Location
United States
Posted
45 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Value Based Coder II
CommonSpirit Health
Role Description The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. - Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. - Advanced Documentation Improvement & Education: Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture. Develop and deliver effective education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture. Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. - Compliance & Regulatory Insight: Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education efforts. Champion a culture of compliance by advocating for best practices and providing robust provider support to ensure CommonSpirit adheres to all federal and coding guidelines pertaining to HCC and risk adjustment. Safeguard medical records and preserve the confidentiality of personal health information through adherence to all relevant policies (release of medical record information, record retention, HIPAA privacy and security). - Process Improvement & Collaboration: Actively participate in network performance improvement initiatives, offering insights and solutions based on coding expertise. Collaborate with providers and office staff to address documentation deficiencies and coding gaps. Qualifications - 2+ years of experience in outpatient coding - 2+ years focused on risk adjustment and HCC principles - Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC coding guidelines and risk adjustment models - Strong understanding of federal and state guidelines on all coding systems and sponsored programs - Proficiency in developing and delivering educational content - Effective interpersonal, communication, and presentation skills (both verbal and written) - Ability to manage multiple priorities and work independently - Computer literacy in medical information systems, records management software, and encoder software Requirements - 4+ years of experience in outpatient coding (preferred) - 3+ years focused on risk adjustment and HCC principles (preferred)
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Clinic Coder II
CommonSpirit HealthCommonSpirit Health is a nonprofit organization that is on a mission to improve people’s health while making “the healing presence of God known.” The orga
Title: Clinic Coder II Location: OMAHA, Nebraska, United States Requisition ID 2026-469305 Department HIM Coding Hours / Pay Period 40 Shift Day Standard Hours M-F Location NE-OMAHA Posted Pay Range $20.86 - $29.46 /hour Company Name CHI Health Clinic Telecommute Yes Department: HIM Coding Job Description: From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours. Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. - Accurately abstract information from the medial records into the appropriate coding systems, ensuring compliance with established guidelines. - Determine the most appropriate diagnosis after a thorough review of the medical records. Work closely with practice staff with regards to coding and assignment of a MS-DRGs (Diagnosis Related Group) and APCs (Ambulatory Payment Classification). - Code medical records using ICD-9-CM and CPT-4 coding rules and guidelines. Ensure through and compliant coding to support patient records and submission of billing for payment. - Accurately sequence diagnostic and procedural codes according to organization specified procedures and assigns MSDRG/APC as appropriate. Provide codes various departments upon request. - Enter and validate charges using appropriate tools and validates diagnoses with the medical documentation provided. - Compare charges on accounts with the procedures coded and identifies any discrepancies. Notify Coding Manager of any discrepancies’ and collaborates as needed to rectify the account. Job Requirements Required - Certified Professional Coder, upon hire or - Certified Professional Coder Hospital Apprentice, upon hire or - Certified Professional Coder Apprentice, upon hire or - Certified Coding Associate, upon hire or - Cardiology Coding, upon hire or - Certified Coding Specialist, upon hire or - Certified Coding Specialist - Physician Based, upon hire or - Certified Cardiovascular and Thoracic Surgery Coder, upon hire or - Certified Health Care Compliance, upon hire or - Certified Interventional Radiology Cardio Coder, upon hire or - Certified Professional Coder Hospital, upon hire or - Radiology Certified Coder, upon hire or - Registered Health Information Administrator, upon hire or - Registered Health Information Technician, upon hire Preferred - Prior Healthcare Billing Experience Apply for this job online Email this job to a friend Share on your newsfeed Connect With Us! Not ready to apply, or can't find a relevant opportunity? Join one of our Talent Communities to learn more about a career at CommonSpirit Health and experience #humankindness.
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Senior Coder
Dignity HealthInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. One of the nation’s largest nonprofit Catholic healthcare organizations. Delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites, and 137 hospital-based locations. Offers home-based services and virtual care offerings. Employs more than 157,000 employees, including 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states. Contributes more than $4.2 billion annually in charity care, community benefits, and unreimbursed government programs. Creates a more just, equitable, and innovative healthcare delivery system with patients, physicians, partners, and communities.
Role Description As a Medical Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Core Coding & Data Integrity: - Applies expert-level knowledge to accurately assign and sequence ICD-10-CM, CPT, and HCPCS codes to outpatient medical records and encounters. - Ensures coding decisions are fully substantiated by medical record documentation and adhere to official coding guidelines, payer requirements, and the Standards of Coding Ethics. - Analyzes APCs (Ambulatory Payment Classifications) and modifier assignments to ensure thorough and compliant coding and charging, utilizing designated coding applications and systems to accurately code and abstract all assigned encounters. Documentation Review & Integrity: - Identifies conflicting, ambiguous, or incomplete documentation within medical records and initiates appropriate physician queries to obtain necessary clarifications. - Works collaboratively with providers and other departments to ensure accurate and complete clinical documentation and resolve charge discrepancies. Productivity, Quality & Confidentiality: - Reviews assigned work queues, prioritizing and coding all assigned encounters within established department productivity and turnaround time frames, consistently meeting quality and accuracy standards set by Coding Leadership. - Complies with all applicable laws, rules, regulations, and organizational policies, including reporting suspected violations. - Maintains strict patient, medical record, department, and employee confidentiality at all times. - Actively participates in professional development, fulfilling continuing education requirements and maintaining professional credentials. - Contributes to a positive team environment and fosters effective communication with colleagues and leadership. Professional Development & Departmental Contribution: - May assist with new hire onboarding, provide mentorship, contribute to audit processes, and various reports. Performs other duties as assigned. - Offers insights and suggestions for enhancing coding workflows, efficiency, and documentation improvement initiatives based on daily coding experience. - Provides feedback on proposed coding policies and procedures, utilizing expert knowledge to identify potential impacts on coding accuracy or workflow. - Offers guidance and shares expertise with less experienced coders on challenging cases or coding complexities, under the direction of leadership and without formal supervisory responsibility. - Actively participates in departmental meetings, contributes to a positive team environment, and fosters effective communication with colleagues and leadership. Qualifications - High School Graduate - Completion of a CAHIIM Approved AHIMA/AAPC Accredited Coding Education and 3 years Coding Experience (Inpatient, Outpatient, Professional Fee, &/or Outpatient Physician Clinics) using ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS coding - Electronic Medical Record (EMR) and encoder experience - Certified Professional Coder - Certified Coding Specialist - Certified Coding Specialist - Physician Based - Certified Professional Coder Hospital - Registered Health Information Administrator - Registered Health Information Technician
