Role Description The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. - Responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. - Responsible for understanding and applying coding knowledge to resolve billing edits related to coding. - Uses Carle electronic medical record systems to review clinical encounters. Qualifications - Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) - Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) - Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC) - Certified Coding Specialist - Physician-Based (CCS-P) - American Health Information Management Association (AHIMA) - Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) Requirements - Knowledge of ICD-10-CM, CPT, and HCPC coding rules and guidelines for code application. - Ability to work with others collaboratively and communicate efficiently, both orally and in writing. - Knowledge of medical science, anatomy and physiology required. - Ability to perform computer data entry. - Experience with encoders or other coding software packages preferred. Responsibilities - Responsible for accurately coding all records according to the appropriate coding classification (ICD-10 and/or CPT and/or HCPCs and modifiers) system. - Provides interdepartmental coding assistance, as needed, to determine accurate coding assignment. - Develops methodology to provide a coding process that is compliant with regulatory agencies. - Facilitates optimization of revenue while maintaining compliance standards for the organization. - Serves as an expert resource regarding CPT, HCPCS, ICD-10-CM, and all other necessary coding systems. - Serves as liaison for coding and billing staff to ensure accurate charge capture. - Reports any documentation and coding improvement needs based upon review findings. - Responsible for maintaining coding certification, knowledge, and skills to successfully perform job duties. - Performs provider and peer coding audits as requested. - Assists with monitoring of internal controls for coding and billing. - Facilitates external audit activities and reporting of such activities to the appropriate administrative personnel. Benefits - The compensation range for this position is $23.58 per hour - $39.38 per hour. - Actual compensation offered will depend on various factors including experience, qualifications, location, training, licenses, shifts worked, and compensation model. - Carle Health offers a comprehensive benefits package for team members and providers.

• Responsible for supervising the work of staff who review, interpret, code and abstract medical records information according to standard classification systems. • Performs the most advanced medical records coding and abstraction duties. • Performs data quality reviews and prepares complex reports as required. • Promotes Coding Audit department goals by selecting, motivating, and training capable team members. • Leads the activities of assigned Coding Audit team members by communicating and providing guidance toward achieving department objectives. • Assists in analyzing common operational definition of metrics and assists in the development of regional reports to monitor individual hospitals in one database and develops processes to integrate clinical department managers in correction and resubmission of medical records. • Assists with the development of tools to track performance including daily reports that track coding operations contribution to the DNFB, including progress toward the resolution of holds; applies data-driven methodologies to understand the current state of coding operations relating to individual hospitals. • Compiles data into reports to identify trends and patterns in procedures; provides regional and local metric information for organization communications. • Evaluates and implements systems, mechanisms, and procedures that ensure timely placement of documents in the patient medical record. • Measures adherence of system(s) developed, handle delays and errors; ensures adherence to high-quality Medical Records standards. • Assists the leadership in development of performance goals, dashboards and medical record chart assembly / delivery procedures; utilizes and reviews tools to track and monitor the prompt resolution of holds and non-coded accounts. • Collaborates with site leadership to prioritize, schedule, assign, and monitor work to optimize operational services; maintains compliance with the policies, procedures and regulations of Medical Records; informs and educates staff of regulatory changes, as needed. • Communicates case write-offs with senior leadership and Business Offices; supervises, hires, trains, disciplines, and evaluates the performance of staff; ensures performance appraisals are completed in a timely manner. • Prioritizes, schedules, assigns and monitors work to optimize operational services; participates in developing and delivering training related to operations. • Performs other related duties as assigned.

Role Description We are seeking an eager, detail-oriented Medical Biller and Coder to join our Revenue Cycle Team at Circle Medical Technologies. This position is eligible for hiring remote U.S. and in the following States; Florida, Texas, or Arizona. - Review patient claims for accuracy and completeness and proactively obtain any missing payer information for inclusion. - Appeal medical insurance claim denials in a timely manner. - Ensure compliance with procedures and coding guidelines. - Answer patient inquiries related to coverage denials and coding reviews for resubmissions as necessary. - Communicate with clinical leadership and third-party billing company on issues regarding CPT & ICD-10 coding selections. Qualifications - Excellent verbal and written communication skills. - Outstanding organizational skills and attention to detail. - Superior time management skills with a proven ability to meet deadlines. - Knowledge of CPT and ICD-10 codes. - Ability to identify coding trends and areas of risk. - Proficient with Google Workspace, Microsoft Office Suite, or related software. Requirements - Associate degree in business, finance, health administration or a related field preferred. - Required - Certified Professional Coder (CPC). - 5+ years of experience in a primary care clinic setting (preferred). - Mental/behavioral health experience is a plus. Benefits - Paid Time Off: Flexible vacation, sick leave, and 12 statutory holidays. - Health & Insurance: Medical, Dental, Vision, Disability, and Life insurance. - Wellness: Mental health programs and an Employee Assistance Program (EAP). - Retirement: 401(k) program with company match. - Development: Annual reimbursement for eligible training and professional programs.

Role Description This position is located in the Health Information Management (HIM) section at the Durham VA Healthcare System. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. - Assigns codes to documented patient care encounters (inpatient and/or outpatient) covering the full range of health care services provided by the VAMC. - Applies advanced knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures, and health services principles for proper code selection. - Selects and assigns codes from current versions of coding systems including ICD, CPT, and/or HCPCS. - Monitors regulatory and policy requirements affecting coded information for services provided by the VAMC. - Performs comprehensive review of patient health records to abstract medical, surgical, ancillary, demographic, social, and administrative data. - Expertly searches patient health records to find documentation justifying code assignment. Lead Functions - Monitors work status and progress, instructs employees in specific tasks, and provides on-the-job training. - Trains and collaborates with staff to develop and maintain ICD and CPT codes for accurate data capture. - Participates in technical evaluation and validation of health records for compliance with standards. - Analyzes and recommends improvements in documentation systems to optimize workload and reimbursement. - Takes initiative in one-on-one provider training to improve health record documentation. - Identifies training needs based on productivity and accuracy reports. - Required to train others on the encoder product suite. Work Schedule Monday-Friday 7am - 3:30pm; This is a 100% remote position. Virtual This is a virtual position. Relocation/Recruitment Incentives Not Authorized Education Requirements Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. - Applicants pending completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Qualifications - One year of creditable experience indicating knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and health records. - OR an associate's degree from an accredited college or university with a major in health information technology/management. - OR completion of an AHIMA approved coding program or other intense coding training program. - OR equivalent combinations of creditable experience and education. Certification - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. English Language Proficiency MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. § 7403(f). GRADE DETERMINATIONS AND ASSIGNMENTS - Lead Medical Records Technician (Coder), GS-9. - Experience equivalent to the journey grade level of a MRT (Coder) and Mastery level certification through AHIMA or AAPC. - Employees at this level must have a mastery level certification. Demonstrated Knowledge, Skills, and Abilities - Ability to work with a team to provide technical guidance and coordinate activities. - Advanced knowledge of current coding classification systems and ability to solve complex coding questions. - Effective communication skills, both orally and in writing. - Knowledge of training methods and ability to provide training to new coding staff. - Ability to collect and analyze data and present results. - Leadership skills, including interpersonal relations and conflict resolution. Preferred Experience - Outpatient coder. Reference For more information on this qualification standard, please visit VA Qualification Standards . Physical Requirements See VA Directive and Handbook 5019, Employee Occupational Health Service.