• Process payments received and create batches for posting. • Identify underpayments and prepare appeals documents. • Code claims accordingly with CPT and ICD 10s codes. • Submit claims to clearinghouses and update or review claims corrections. • Communicate with patients, providers, and payers to check eligibility, pre-certify, or follow up on claims and appeals • Perform other duties as assigned by management

Role Description The inpatient senior coder will thoroughly review inpatient record accounts to assign correct ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes per industry coding guidelines, utilizing the 3M computer assisted coding software application. Abstracts coded data from the Epic electronic medical record according to the established standard of work, while maintaining established quality accuracy and productivity standards. Works collaboratively with leadership, financial and clinical teams to ensure Diagnostic Related Groups (DRG) or All Patient Refined Diagnostic Related Groups (APR-DRG) accuracy. The outpatient senior coder will review multiple service lines of outpatient services (ambulatory surgery, observation, interventional radiology/cardiology, emergency) record accounts to assign correct ICD-10-CM diagnosis codes, CPT procedure codes, add modifiers, review claim edits, etc. per the industry coding guidelines, utilizing the 3M computer assisted coding software application. Abstract coded data from the Epic electronic medical record according to the established standards of work, while maintaining the established quality accuracy and productivity standards. Essential Functions - Consistently Meets Monthly Productivity Standard: ≥100% - Consistently Meets Biannual Quality Standard: ≥95% - Use of an electronic medical record and encoder in a remote work environment. - Codes outpatient or inpatient records according to coding guidelines and conventions. - Assigns diagnoses and procedures for billing process, data retrieval and research purposes, using numerical codes of ICD-9-CM/ICD-10-CM/PCS and CPT-4 coding. - Provides education and training regarding coding guidelines of specialty area to clinical and non-clinical staff. - Communicates, collaborates and acts as a team player with others in order to ensure continuity of services. - Optimize codes for reporting and generates APCs for all outpatient records. - Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. - Participate in process improvement activities including but not limited to assuring accounts that cannot be coded are held for valid reasons. - Must attend all staff meetings required by management. Qualifications - High School Diploma or equivalent - 2 years of relevant experience coding - 1 of 5 certifications: - CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association Upon Hire - CRT-Registered Health Information Technician (RHIT) - AHIMA American Health Information Management Association - CRT-Registered Health Information Administrator (RHIA) - AHIMA American Health Information Management Association - CRT-Professional Coder – AAPC / American Academy of Professional Coders - CRT-Outpatient Coder, Certified (COC) - CPC – Certified Professional Coder Requirements - Associate’s degree in health information technology/management (Preferred) - Bachelor's degree Health information technology/management (Preferred) - ICD-10-CM, ICD-10-CPS, CPT coding experience (Preferred) Benefits - Comprehensive benefits package to meet your financial, health, and work/life balance goals. - On-demand pay program powered by Payactiv. - Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! - Optional identity theft protection, home and auto insurance. - Traditional and Roth retirement options with service contribution and match savings. - Eligibility for benefits is determined by employment type and status.

• Independently perform complex, specialty-specific professional fee coding (CPT/HCPCS and ICD-10-CM) for physician services rendered in both office and hospital settings • Ensure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standards • Identify the need for formal clinical queries for documentation clarification when necessary for professional or facility records • Maintain high accuracy and productivity standards appropriate to the complexity of the assigned workload • May provide informal guidance to new coding staff on professional coding nuances

Role Description The Hospital Outpatient Coding Educator is a fully remote coding position responsible for developing training content and materials and conducting outpatient coding training for the hospital outpatient coding staff. This position ensures training practices are standardized and result in consistent coding outcomes, as well as provides input regarding the content of policies and procedures. - Develops and maintains all corporate coding education, training policies and procedures, and coding reference materials. - Leads training sessions and assesses coder comprehension of covered materials. - Makes recommendations for the development of coding resources and policy and procedure development. - Assists corporate coding leadership with training and/or development of a performance improvement track for coding coworkers in the corrective action process related to quality or productivity performance. - Coordinates with Coding Auditors to prepare education material based on audit results. - Develops and maintains a consistent coding operations orientation program and reports the coders' progress to coding leadership throughout the orientation and training processes. - Acts as a nosologist, analyzing and interpreting disease and procedure classifications and terminologies for the accurate translation of healthcare data. - Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. - Maintains expert knowledge of Franciscan Alliance coding software tools. - Assists with development and maintenance of software system workflow for standardization and maximum efficiency. - Oversees system testing with regards to any published software updates or software functionality changes. Qualifications - High School Diploma/GED with 5 years of Franciscan coding experience - Required - Associate's Degree - Required - Bachelor's Degree - Preferred - Surgery Coding Experience - Required - 5 Years Franciscan outpatient coding with CCS, CCS-P, CPC - Required - 5 Years Outpatient Coding Experience with RHIT/RHIA - Required - 3 Years Coding Manager or Trainer/Auditor - Preferred - CCS, Certified Coding Specialist from American Health Information Management Association (AHIMA) - Required - CPC, Certified Professional Coder from the American Academy of Professional Coders (AAPC) - Required - CCS-P, Certified Coding Specialist - Physician from the American Health Information Management Association (AHIMA) - Required - RHIT, Registered Health Information Technician from American Health Information Management Association (AHIMA) - Preferred - RHIA, Registered Health Information Administrator from American Health Information Management Association (AHIMA) - Preferred - Proficient in Excel, Word and PowerPoint - Required - Detail Oriented - Required Requirements - Travel is required: Never or Rarely - Job Range: Coding Educator - Hospital Outpatient/Professional $51,001.60 - $75,868.00 - Incentive: Not Applicable Benefits - Comprehensive benefit offerings available for eligible employees.