• Manage the end-to-end medical billing and revenue cycle process for home healthcare services • Process and submit medical claims accurately and efficiently • Verify patient insurance eligibility and benefits • Track, monitor, and follow up on submitted insurance claims • Investigate and resolve claim denials, billing discrepancies, and reimbursement issues • Coordinate with Massachusetts insurance carriers regarding claims processing and payments • Maintain accurate billing records and documentation within CollaborateMD • Ensure billing practices remain compliant with HIPAA standards and regulations • Provide administrative support related to billing and reimbursement operations • Support inbound and outbound communication with patients and insurance providers as operational needs expand

Role Description The VA Northeast Ohio Healthcare System is recruiting for a Medical Records Technician (Coder-Inpatient) position. The Medical Records Technician (Coder-Inpatient) is located in the Health Information Management Services (HIMs) section within Patient Care Administrative Service. - Reviewing record documentation to abstract all required medical, surgical, ancillary, demographic, social, and administrative data, and query clinical staff, as appropriate, with guidance from higher level MRTs (Coder). - Using various computer applications to abstract records, assign codes, and record and transmit data. Ensuring audit findings have been corrected and refiled. - Assigning codes to documented patient care encounters (inpatient and outpatient); encounters are routine and less complex or for only one specialty or subspecialty. - Maintaining current knowledge of regulatory and policy requirements affecting coded information. - Consulting with a more senior coder or the supervisor to resolve issues related to conflicting or questionable clinical documentation. - Utilizing the facility computer system and software applications to code, abstract, record, and transmit data to the national VA database in Austin. - Correcting any identified data errors or inconsistencies in a timely manner to ensure acceptance in the national VA database within established timelines. - Researching references to resolve any questionable code errors; contacting a senior coder or supervisor when needed. - Identifying significant complications and/or co-morbidities treated or impacting treatment to correctly determine the proper Diagnosis Related Group (DRG). - Establishing the primary and secondary diagnosis and procedure codes for billable outpatient encounters for one specialty or subspecialty. - Updating ICD diagnosis and procedure codes for the quarterly inpatient and Contract Nursing Home census for assigned inpatient admissions. Qualifications - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - English Language Proficiency: MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. § 7403(f). - Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management. - Certification: Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA must possess one of the following certifications: - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. Requirements - Experience or Education: None beyond basic requirements for GS-4. - For GS-5: One year of creditable experience equivalent to the next lower grade level; or successful completion of a bachelor's degree from an accredited college or university recognized by the U.S. Department of Education. - For GS-6: One year of creditable experience equivalent to the next lower grade level. - For GS-7: One year of creditable experience equivalent to the next lower grade level. - For GS-8: One year of creditable experience equivalent to the next lower grade level. Benefits - Work Schedule: Monday- Friday, 8:00am - 4:30pm - Remote: This position is designated as remote. Applicants must live within 50 miles of one of our facilities. - Relocation/Recruitment Incentives: Not Authorized - Permanent Change of Station (PCS): Not authorized

Role Description We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! What You Will Do: - Review medical records and assign accurate codes for diagnoses and procedures. - Assign and sequence codes accurately based on medical record documentation. - Assign the appropriate discharge disposition. - Abstract and enter the coded data for hospital statistical and reporting requirements. - Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution. - Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards. - Be responsible for tracking continuing education credits to maintain professional credentials. - Attend Datavant Health sponsored education meetings/in-services. - Demonstrate initiative and judgment in the performance of job responsibilities. - Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues. - Function in a professional, efficient, and positive manner. - Adhere to the American Health Information Management Association’s code of ethics. - Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn. - Handle a high complexity of work function and decision-making. - Possess strong organizational and teamwork skills. - Comply with all HIM Division Policies. Qualifications - AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC). - 2+ years of coding experience in a hospital and/or coding consulting role. - Proficiency with most or all of these coding specialties (Same Day Surgery, Observation, Injections/Infusions). - Proficiency with most or all of these coding specialties (Ancillary, Emergency Department, Injections/Infusions, E/M leveling). - Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills. - Experience in computerized encoding and abstracting software. - Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually. Requirements - Minimum of 3+ years of outpatient coding experience. - Systems are Dolbey Fusion, Trucode and Epic/Solventum. Benefits - Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays. - Benefits for PRN employees: 401k savings plan w/match. - Free CEUs every year. - Stipend provided to assist with education and professional dues (AHIMA/AAPC). - Equipment: monitor, laptop, mouse, headset, and keyboard. - Comprehensive training led by a credentialed professional coding manager. - Exceptional service-style management and mentorship (we’re in this together!). - Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. - The estimated base pay range per hour for this role is: $20 — $28 USD.

Role Description Please Note: This is a pool position. No guarantee of hours. Certified Coders have the option to work virtually. Must reside in the state of WA, OR, ID, WI, FL, MT, GA, TX, AZ, AL, TN. The Certified Medical Coder will be responsible for: - Reviewing all medical record information to extract data and apply appropriate diagnoses and procedure codes for billing, internal and external reporting, research, and regulatory compliance. - Accurately coding conditions and procedures as documented in the Official Guidelines for Coding and Reporting for Hospital Departments. - Acting as a coding resource for team members and medical staff, ensuring compliance with ICD-10CM/PCS, CPT & HCPCS guidelines. - Assigning codes utilizing an electronic encoder application in accordance with practice policy and regulatory guidelines. - Abstracting and assigning ICD-10-CM/PCS, CPT, or HCPCS codes per coding guidelines. - Assisting with coding audits rebuttals from payor and RAC audits when due to coding. Position Reports To: Coding Department Manager Essential Functions - Reviews accounts and charges in EPIC. - Codes all records based on documentation, following coding guidelines, payer regulations, and ethics. - Demonstrates knowledge of CMS Hierarchical Condition Category (HCC) Risk Adjustment coding. - Applies knowledge of coding rules, reviews, and resolves CCI/LCD/NCD’s and modifier edits. - Effectively uses software and/or coding books to verify coding accuracy. - Responsible for staying current with billing guidelines and reimbursement rules and regulations. - Works with Revenue Integrity & Compliance on audits and coding questions. - Contributes as a team member with Clinical Documentation Specialists. - Provides feedback to providers regarding incorrect coding using authorized methods as directed by department policy. - Works with clinical staff to resolve coding issues and related problems. - Participates in educational activities as requested (i.e., attending meetings with clinical staff). - Maintains department coding production standards for the specialties assigned. - May be requested to perform job tasks not specifically related to primary assignments for the success of the organization. - Other duties as assigned. Certified Professional Coder Functions - Hospital Professional Coders are responsible for coding charges for Inpatient/Outpatient Hospital, Emergency Department, and/or Ambulatory Surgical Center. - Clinic Outpatient Professional Coders are responsible for coding multiple specialties with a broad range of health care facility types. - Utilizes ICD-10CM, CPT, Modifiers, and HCPCS codes for reporting diagnosis and procedures per coding guidelines. - Reviews charge session for appropriate billing provider, department, and place of service. - Ability to level E/M visits and extract procedure codes. - Receives paper charge tickets or invoices, appropriately codes them, creates HARs, and batches or unit charge entry into EPIC. - Demonstrates Standards of Behavior and adheres to the Code of Conduct in all aspects of job performance at all times. Qualifications - High School graduate or equivalent. - One of the following coding certifications: CPC, CIC, COC from AAPC or CCA, CCS, RHIA, RHIT from AHIMA. - Minimum 1 year coding experience or equivalent education/experience. - Knowledge of ICD-10, CPT coding, medical terminology, and insurance billing. - Understanding of DRG’s for Inpatient Facility coding positions. - Possesses basic computer skills (e.g., spreadsheets, word processing). Desired - Experience with EPIC EHR. - Facility coders: Experience with Nuance Clintegrity encoder system. - Second coding certification from AAPC or AHIMA. Physical/Sensory Demands - Walking - Frequent - Sitting/Standing - Continuous - Reaching: Shoulder Height - Frequent - Reaching: Above shoulder height - Frequent - Reaching: Below shoulder height - Frequent - Climbing - Occasional - Pulling/Pushing: 25 pounds or less - Occasional - Pulling/Pushing: 25 pounds to 50 pounds - Occasional - Pulling/Pushing: Over 50 pounds - Occasional - Lifting: 25 pounds or less - Occasional - Lifting: 25 pounds to 50 pounds - Occasional - Lifting: Over 50 pounds - Occasional - Carrying: 25 pounds or less - Occasional - Carrying: 25 pounds to 50 pounds - Occasional - Carrying: Over 50 pounds - Occasional - Crawling/Kneeling - Occasional - Bending/Stooping/Crouching - Frequent - Twisting/Turning - Frequent - Repetitive Movement - Frequent Working Conditions - Normal office environment or optional remote work in approved state. Job Classification - FLSA: Non-Exempt - Hourly/Salary: Hourly Physical Exposures For This Position - Unprotected Heights - No - Heat - No - Cold - No - Mechanical Hazards - No - Hazardous Substances - No - Blood Borne Pathogens Exposure Potential - No - Lighting - No - Noise - No - Ionizing/Non-Ionizing Radiation - No - Infectious Diseases - No