Role Description As our Clinic Coder II, you will be instrumental in the financial health and operational integrity of our healthcare ministry. Your primary responsibility will be to accurately abstract and code patient records in compliance with established coding, billing, and data collection guidelines. You'll play a critical role in optimizing revenue cycle management, ensuring compliant data submission, and contributing to the overall success of our clinic's financial services. - Meticulously review medical records to determine the most appropriate diagnoses, utilizing ICD-9-CM and CPT-4 coding rules and guidelines. - Work closely with practice staff on MS-DRG and APC assignments. - Accurately sequence diagnostic and procedural codes. - Validate charges against medical documentation. - Identify and resolve discrepancies in coded charges. - Collaborate with management to ensure accurate account rectification. - Uphold the highest ethical standards in medical billing. To be successful in this medical coding specialist role, you will need a strong understanding of healthcare billing, robust knowledge of medical insurance, payer contracts, and automated systems. You'll possess exceptional attention to detail, critical thinking skills, and a commitment to accuracy, maintaining strict confidentiality of medical records. Candidates with professional coding certifications (CPC, CCS, RHIT, RHIA, etc.) and experience in a revenue cycle optimization environment are highly desired, demonstrating your ability to thrive with limited oversight in a financial services in healthcare setting. Qualifications - Strong understanding of healthcare billing. - Robust knowledge of medical insurance and payer contracts. - Exceptional attention to detail. - Critical thinking skills. - Commitment to accuracy and confidentiality of medical records. - Professional coding certifications (CPC, CCS, RHIT, RHIA, etc.) preferred. - Experience in a revenue cycle optimization environment preferred. Requirements - Certified Professional Coder, upon hire. - Certified Coding Associate, upon hire. - Cardiology Coding, upon hire. - Certified Coding Specialist - Physician Based, upon hire. - Certified Cardiovascular and Thoracic Surgery Coder, upon hire. - Registered Health Information Administrator, upon hire. - Prior Healthcare Billing Experience (preferred).

• responsible for reviewing and analyzing documentation present in the medical record for inpatient, outpatient and/or professional services • assign diagnoses/procedure codes as described by the physician(s) of record • abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines

• Support Medical Policy Team’s operations • Create and manage monthly Medical Policy production timelines • Maintain Medical Policy material distribution lists • Verify that the monthly authorization table updates align with quality expectations • Support virtual Medical Policy Committee (MPC) operations • Partner with the coding specialist role in support of the Medical Policy Implementation Committee (MPIT) • Support Medical Policy leadership in initial research on impact of changes in vendor and BCBSA Reference Medical Policy changes • Monitor and triage Medical Policy inbox for external inquiries • Perform monthly medical policy coding analyses and SAP BusinessObjects reports • Ensure that all documentation related to health policy decisions is complete and accurate • Update system configurations for accurate administration of health policies • Participate in cross-functional meetings or initiatives to support the enterprise strategic priorities

• Support Medical Policy Team’s operations, including managing Medical Policy timelines • Verify that monthly authorization table updates align with quality expectations • Participate in cross-functional meetings to support enterprise strategic priorities • Perform monthly medical policy coding analyses and SAP BusinessObjects reports • Ensure documentation related to health policy decisions is complete and timely