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    Evaluation/Management Certified Coder | Usa

    Advantum Health Logo
    2+ years
    Not Disclosed
    Remote, USA
    10 Nov. 13, 2024
    Job Description
    Job Type: Full Time Remote Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

    Job Title: Certified Medical Coder – Revenue Cycle Management

    Job Summary:
    The Certified Medical Coder is responsible for ensuring accurate coding of all visits and surgeries, supporting ongoing Revenue Cycle Performance/Management, and customer satisfaction. The Coder will act as a resource for clients and the accounts receivable team, particularly for coding-related denials, and will support the education and training of providers and staff in coding and documentation practices.

    Qualifications:

    • CPC Certification through AAPC or AHIMA (Required)
    • In-depth knowledge of clinical workflow
    • Expert in Microsoft Office products (Word, Excel, PowerPoint)
    • Ability to perform production-level coding
    • 3+ years of specialty-specific coding experience
    • Training experience preferred
    • Expert knowledge of CCI edits
    • Revenue Cycle Management (RCM) experience (Required)
    • Denial management and appeals experience (Preferred)
    • Strong verbal and written communication skills
    • Ability to pass medical coding assessment
    • COSP (Certified Outpatient Coder) preferred

    Responsibilities:

    • Perform medical record reviews for CPT and ICD-10 coding accuracy
    • Train providers and coding staff on charge capture platforms
    • Work with the Education Supervisor on system updates and ongoing provider/staff training
    • Assist in creating and maintaining ICD-10 CM, CPT/HCPCS coding rules and pick lists for providers
    • Educate providers and staff on key revenue cycle topics, including ICD-10, CPT/HCPCS, E/M coding, documentation, billing policies, and compliance
    • Analyze coded data to ensure documentation accuracy
    • Provide re-education for providers when documentation is inaccurate
    • Educate providers on correct documentation per CMS guidelines to ensure appropriate billing
    • Conduct concurrent coding reviews for new hires and coding staff
    • Provide timely feedback to management on coding issues
    • Assist in developing training and educational materials to address documentation and coding deficiencies
    • Coordinate new hire education and training schedules
    • Interact with providers to resolve conflicting documentation or clarify through the query process
    • Review platform upgrades and update departmental documentation as necessary
    • Report system issues and assist with resolving training workflow complexities
    • Stay current on coding updates and communicate changes to providers and coders
    • Work with management to identify denials and develop education to reduce future claim rejections
    • Understand and apply Medicare billing rules (LCD/NCD/CCI)
    • Advanced proficiency in MS Excel, Word, and PowerPoint
    • Ensure compliance with HIPAA regulations in handling Protected Health Information (PHI)
    • Perform other duties as assigned by management

    Work Environment:

    • Office-based with potential for remote work

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