• Accurately assign and appropriately sequence ICD-10 and CPT codes and all applicable modifiers • Contact clients as appropriate when documentation in the medical record is inadequate, ambiguous or unclear for coding purposes • Monitor regulatory and payer changes as they apply to diagnostic and procedure coding • Research and resolve coding related system edits, payer rejections and insurance denials • Identify system edit, payer rejection, and insurance denial trends for client policy and procedure improvement • Maintain up to date knowledge of the current changes of coding practices by continuing education and reading resource material • Other innovative and progressive duties as assigned

Role Description This position supports Mercy's philosophy of patient centered care by the timely and accurate coding of hospital or professional services using ICD-10-CM/PCS and CPT/HCPCS classification systems for the purpose of reimbursement, research, and statistics in compliance with federal regulations. Qualifications - Knowledge of ICD-10-CM/PCS and CPT/HCPCS coding and medical necessity guidelines. - Knowledge of various coding groupers used for various payers and types of encounters. - Ability to read and interpret medical record documentation including laboratory and pharmacology data. - Knowledge of Microsoft Office tools (Excel, Outlook, Word). - Strong computer background with basic typing and keyboarding skills. - Work prioritization skills needed. - Ability to concentrate on detailed tasks for long periods of time. - Ability to work independently with frequent interruptions. - Excellent interpersonal communication (verbal, non-verbal, and listening) skills and written communication skills. - Knowledge of hospital payment systems and federal and state regulations related to billing, coding, and compliance. Requirements - Five years previous coding experience required. - Education sufficient to obtain certification. - AHIMA or AAPC coding certification (e.g. RHIT, RHIA, CCA, CCS, CCS-P, CPC) is required. Company Description Mercy is an independent, community-based organization supporting the Cedar Rapids area for over 120 years. Mercy is an equal-opportunity employer. We value diversity, equity, and inclusion and therefore evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status, and other legally protected characteristics.

Role Description The Coder is responsible for coding diseases, procedures, and operations for professional and facility services within Altru Health System. In addition, the Coder is responsible for effective communication and partnerships with providers that includes shared feedback and on-going education regarding coding criteria and standards. The Coder monitors daily activity reports to assure all encounters are being coded and performs documentation review and audits to validate coding efforts. - Utilizes the electronic medical record to code diseases, procedures, and operations with the current diagnosis and procedure classifications for both professional and facility services. - Accesses designated resources such as coding initiatives, local medical review policies, HCPCS, Coders Desk Reference, etc. to research appropriate codes for adherence with coding guidelines. - Partners with providers for quality, optimum coding by engaging in on-going feedback on updated coding criteria and guidelines. - Communicates current procedure and diagnosis coding guidelines with providers. Serves as a resource regarding documentation and coding issues. - Assists Business Office staff in the resolution of coding related denials guidelines and takes corrective action for claim resubmission for reimbursement. - Monitors daily activity reports to assure all encounters are being coded and submitted for billing. - Performs documentation review and audits to validate coding. Works with physicians and leaders to interpret coding data reports and trends. - Performs other duties as assigned or needed to meet the needs of the department/organization. Qualifications - Certified Coding Associate (CCA) | American Health Information Mgmt. (AHIMA) | Within 12 Months of Start Date | HR Primary Sources - Certified Coding Specialist (CCS) | American Health Information Mgmt. (AHIMA) | Within 12 Months of Start Date | HR Primary Sources - Certified Coding Specialist - Physician Based (CCS-P) | American Health Information Mgmt. (AHIMA) | Within 12 Months of Start Date | HR Primary Sources - Certified Professional Coder-Hospital Outpatient (CPC-H) | American Academy of Professional Coders | Within 12 Months of Start Date | HR Primary Sources - Certified Professional Coder (CPC) | American Academy of Professional Coders | Within 12 Months of Start Date | HR Primary Sources - Registered Health Information Technician (RHIT) | American Health Information Mgmt. (AHIMA) | Within 12 Months of Start Date | HR Primary Sources Requirements - May be certified in one of the above. - This position requires proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members. Physical Demands - Sit: Frequently (34-66%) - Stand: Occasionally (5-33%) - Walk: Occasionally (5-33%) - Stoop/Bend: Occasionally (5-33%) - Reach: Frequently (34-66%) - Crawl: Not Applicable - Squat/Crouch/Kneel: Rarely (1-4%) - Twist: Occasionally (5-33%) - Handle/Finger/Feel: Continuously (67-100%) - See: Continuously (67-100%) - Hear: Continuously (67-100%) Weight Demands - Lift - Floor to Waist Level: Sedentary (<10 pounds) - Carry: Sedentary (<10 pounds) - Push/Pull: Sedentary (<10 pounds) - Slide/Transfer: Not Applicable Working Conditions - Indoor: Continuously (67-100%) - Outdoor: Not Applicable - Extreme Temperature: Not Applicable Driving Requirement - Infrequent Driver Benefits - Comprehensive benefits package for full- and part-time employees. - Health plan and 401(k) retirement plan. - Dental plan. - Vision plan. - Life and disability insurance. - Education assistance. - Paid time off (PTO).

Role Description The Medical Billing Specialist is responsible for managing third-party billing and collections activities to ensure the timely and accurate submission, processing, and resolution of medical and pharmacy claims. The ideal candidate has experience with home infusion billing, payer reimbursement guidelines, and medical billing practices, along with strong analytical, communication, and problem-solving skills. - Manage third-party billing and collections activities. - Ensure the timely and accurate submission of claims. - Meet quality assurance standards, productivity goals, and performance benchmarks. - Identify and update patient and insurance information changes. - Process home infusion and nursing claims. - Review and resolve NCPDP claim rejections, including resubmissions and appeals as appropriate. - Analyze billing trends and identify opportunities for process improvement. - Maintain accurate documentation and records. - Perform other duties as assigned. Qualifications - Strong verbal and written communication skills with patients, payers, external agencies, and internal stakeholders. - Professional, courteous, and customer-focused approach. - Ability to interpret and apply instructions received through various communication methods. - Knowledge of home infusion services and related billing practices. - Understanding of insurance policies, payer requirements, and reimbursement processes. - Knowledge of medical billing methodologies and reimbursement regulations. - Ability to maintain confidentiality and handle sensitive information with discretion. - Strong organizational skills with excellent attention to detail. - Ability to manage multiple priorities in a fast-paced environment. - Basic mathematical proficiency, including addition, subtraction, multiplication, and division. - Strong problem-solving, time management, and critical-thinking skills. - Ability to work independently and collaboratively within a team environment. - Knowledge of ICD-10, CPT, HCPCS codes, and medical terminology preferred. - Proficiency with Microsoft 365 applications. - Experience with HCN 360 and/or CPR+ preferred. - Working knowledge of Medicare billing requirements, including DME MAC guidelines preferred. Requirements - High school diploma or GED required. - One to three years of related billing, collections, or healthcare revenue cycle experience. - Experience in a medical, healthcare, or home infusion environment preferred. - Experience with medical billing and administrative record management. - Strong customer service and interpersonal skills. - Excellent organizational, communication, and problem-solving abilities. Preferred Qualifications - Home infusion billing or collections experience. - Experience billing both medical and pharmacy claims. - Familiarity with Medicare, commercial payers, and reimbursement regulations. - Experience working with claim denials, appeals, and reimbursement resolution. Benefits - If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.