• Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. • Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. • Review provider documentation (including hospital procedures) and translate services into correct codes. • Append payer specific modifiers and claim criteria when applicable. • Review incomplete encounters and code based on available documentation in EHR systems. • Know and understand several different coding systems, including ICD-10-CM, ICD-10-PCS, CPT, Level 1 HCPCS and Level 2 HCPCS. • Use computers / billing software to create and bill encounters that generate clean claims. • Attend internal meetings relevant to EHR workflows and share best coding practices. • Assist Operations when coding guidance is requested for existing or new services. • Understand payer reimbursement and PPS visit qualification for Medicare and Medicaid. • Trend areas of focus where provider training or re-training is needed. • Monitor, trend and resolve tasks related to coding edits, rejections, and denials. • Communicate with providers, patients, and insurance payers. • Review patient accounts and correct any missing or inaccurate information. • Investigate and appeal claims that were denied incorrectly. • Complete coding projects such as quarterly or ad hoc provider chart audits. • Adapt to updates and changes in billing software. • Perform all other duties and tasks as assigned.

• You will code hospital and professional inpatient visits using the International Classification of Disease 10-Clinical Modification (ICD-10-CM) and Current Procedure Terminology (CPT) coding methodology in accordance with official coding and reimbursement guidelines • You will work under the general supervision and reporting to the Director of HIM • You are responsible for professional CPT coding for Medicare and Medicare like payers • You will abstract all data elements into the WellSky EMR platform • You will use the TruBridge encoder integration to review Medical Necessity edits and CCs, MCCs, coding order and DRG assignment • You will maintain current working knowledge with all coding rules, coding guidelines, Medicare, and Medicare like payer regulations in accordance with the hospital coding compliance policies and procedures

• Provides direct supervision, mentorship, and daily operational oversight of the Lead Certified Professional Coder and coding staff • Supports staffing, scheduling, workload distribution, and productivity management • Assists with onboarding, training, coaching, and performance evaluations of coding staff • Promotes accountability, collaboration, and professional development within the team • Performs and oversees charge review to determine appropriate CPT and ICD-10 codes for physician services • Ensures compliance with CMS, regulatory, and third-party payer guidelines

Role Description As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. - Accurately translate patients’ medical records into standardized codes for diagnoses and treatments. - Ensure compliance with legal, regulatory, and organizational standards. - Combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. - Maintain clear communication with providers and staff to ensure claims are processed correctly and on time. - Accurately abstract information from the medical records into the appropriate coding systems. - Determine the most appropriate diagnosis after a thorough review of the medical records. - Work closely with practice staff regarding coding and assignment of 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 thorough and compliant coding to support patient records and submission of billing for payment. - Accurately sequence diagnostic and procedural codes according to organization specified procedures. - Provide codes to various departments upon request. - Enter and validate charges using appropriate tools and validate diagnoses with the medical documentation provided. - Compare charges on accounts with the procedures coded and identify any discrepancies. - Notify Coding Manager of any discrepancies and collaborate as needed to rectify the account. Qualifications - Certified Professional Coder, upon hire - Certified Professional Coder Hospital Apprentice, upon hire - Certified Professional Coder Apprentice, upon hire - Certified Coding Associate, upon hire - Cardiology Coding, upon hire - Certified Coding Specialist, upon hire - Certified Coding Specialist - Physician Based, upon hire - Certified Cardiovascular and Thoracic Surgery Coder, upon hire - Certified Health Care Compliance, upon hire - Certified Interventional Radiology Cardio Coder, upon hire - Certified Professional Coder Hospital, upon hire - Radiology Certified Coder, upon hire - Registered Health Information Administrator, upon hire - Registered Health Information Technician, upon hire Requirements - Prior Healthcare Billing Experience (Preferred)