Role Description The Coder Abstractor is responsible for the charge capture process for professional charges within the Munson system, including but not limited to: - Verifying and/or analyzing medical record and/or encounter form documentation to determine the principal and all secondary diagnoses and procedures. - Assigning diagnostic codes, procedural codes, and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS) and Munson. - Performing data entry and discrepancy resolution. - Serving as a liaison between CBO and sites/departments. - Assisting in the orientation and training of new employees within the coding and charge capture area. - Reviewing office-based electronic charges and encounter forms for completion and accuracy, including accuracy of ICD9/10CM, CPT, and HCPCS modifier assignment. - Working with the central billing team to ensure charges are coded and entered within two business days. - Identifying educational needs and/or compliance issues and reporting them to the Director of Central Billing Office. - Researching and responding to coding and compliance questions, coordinating accurate assignment of procedure codes and modifiers. - Performing other duties as assigned. Qualifications - Associate’s degree in Health Record Technology, or related healthcare field and two years of professional coding experience, and must obtain the credentials of a Certified Professional Coder (CPC), Registered Health Information Administrator (RHIT), or Registered Health Information Administrator (RHIA) within 18 months of employment. - OR three years of professional coding experience and has obtained the credentials of a Certified Professional Coder (CPC), Registered Health Information Administrator (RHIT), or Registered Health Information Administrator (RHIA). - OR four to five years of professional coding experience and must obtain the credentials of a Certified Professional Coder (CPC), Registered Health Information Administrator (RHIT), or Registered Health Information Administrator (RHIA) within 18 months of employment. - Fully remote! Must have at least two years of cardiology coding experience. Requirements - Munson Healthcare requires all employees to be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella, and Varicella. - MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption. Benefits - Tuition reimbursement, in-person and online development, and access to our career hub to help you advance. - Full benefits, paid holidays, generous PTO, employee discounts, and free individual retirement counseling. - Free wellness platform for you and your family, plus personalized support for personal or family challenges. - Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings.

Role Description The role involves managing medical billing and claims with a focus on accuracy and efficiency. - Prepare, review, and submit a high volume of insurance claims daily. - Manage the full billing workflow from claim creation through payment posting and account follow-up. - Submit claims accurately to clearinghouses and ensure timely processing. - Monitor claim status and proactively resolve billing issues. - Investigate, appeal, and resolve claim rejections and denials from start to finish. - Identify billing errors, make necessary corrections, and promptly resubmit claims. - Maintain a strong understanding of Coordination of Benefits (COB) to ensure accurate claim processing. - Apply CPT and HCPCS modifiers correctly based on payer requirements and clinical documentation. - Ensure compliance with insurance payer guidelines across multiple commercial and government payers. - Communicate professionally with healthcare providers regarding documentation and billing questions. - Assist patients or parents/guardians with billing inquiries and account balances. - Collect payments over the phone and establish payment arrangements while providing excellent customer service. Qualifications - Extensive hands-on experience in medical billing with a proven track record of managing high claim volumes. - Strong experience submitting claims to insurance clearinghouses. - Demonstrated success resolving claim rejections and denials through to payment. - Thorough understanding of Coordination of Benefits (COB). - Strong knowledge of CPT/HCPCS coding modifiers and their appropriate application. - Solid understanding of insurance payer guidelines and billing requirements across multiple payers. - Ability to identify billing issues, correct claims, and resubmit them with minimal supervision. - Experience managing the complete medical billing lifecycle from claim submission through payment posting and collections. - Strong analytical, organizational, and problem-solving skills. - Ability to work independently while managing multiple priorities in a fast-paced environment. Preferred Qualifications - Experience using AdvancedMD (strongly preferred). - Experience communicating directly with providers regarding documentation and billing issues. - Experience assisting patients or parents/guardians with billing questions. - Comfortable collecting payments by phone and establishing payment plans. - Experience working with multiple insurance carriers and specialty practices. What We're Looking For The ideal candidate has been deeply involved in every aspect of the medical billing process—not someone whose recent experience has been limited to supervising a billing team. You should have a comprehensive understanding of the entire revenue cycle, be able to troubleshoot billing challenges independently, and consistently keep claims moving efficiently from submission through reimbursement. If you're detail-oriented, proactive, and thrive in a fast-paced billing environment, we'd love to hear from you.

• Responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. • Ensure coding accuracy, regulatory compliance, appropriate reimbursement, and adherence to client-specific coding guidelines, payer requirements, and industry standards. • Review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits. • Accurately assign facility Evaluation and Management (E/M) levels in accordance with client-specific emergency department leveling guidelines and facility charging methodologies, including knowledge of the ACEP tool. • Analyze documentation from nursing staff, physicians, ancillary departments, and diagnostic services to ensure complete code assignment and charge capture. • Apply official coding guidelines, CMS regulations, National Correct Coding Initiative (NCCI) edits, and payer-specific requirements. • Participate in coding quality reviews, audits, educational initiatives, and process improvement activities.

• Complete assigned development tasks using Codex, Claude, or similar AI coding tools • Work independently while following project requirements and coding standards • Ask clarifying questions early to ensure a strong understanding of assigned work • Develop, test, and troubleshoot code as needed • Participate in periodic check-ins to provide progress updates • Maintain clean, organized, and well-documented code • Identify issues and recommend solutions during development • Collaborate with the client to ensure tasks are completed accurately and efficiently