Title: Coder II
Job Description
RCM360 is looking for motivated, dynamic Coder. You will be responsible for abstract coding of medical and possibly dental record documentation, as well as review and correction of coding-related charge review and claim edits, with or without review of medical record documentation, to ensure accurate and timely submission of professional fees. Coder II will focus on complex coding, such as procedural/surgical coding and/or specialty service evaluation and management services. Additionally, Coder II will have responsibility for resolving coding-related denials.
Coder II ensures the medical/dental record reflects adequate documentation consistent with Medicare rules and national correct coding initiative (NCCI) guidelines. Coder II is also responsible for identifying coding error trends and working with their supervisor, team and client to facilitate root cause analysis and continuous process improvement.
About
RCM360 is a St. Louis area-based team of eClinicalWorks billing and optimization specialists with years of experience helping practices with their revenue cycle management needs. We’ve worked with hundreds of providers and seen firsthand the challenges they face with their billing, collections, and revenue growth strategies. That experience has allowed us to develop a solution which routinely results in increased cash flow, reduction in rejected claims and more efficient billing and collection processes. For more information about RCM360, visit: www.rcm360.net.
Overall Responsibility
· Experienced in Orthopedic/Spine/Pain and FQHC preferred
Work effectively as a team member
· Ensure quality standards are achieved and deadlines met
· Communicate effectively with clients and team members
· Manage assigned charge review and coding-related claim work queues to ensure timely and accurate charge capture.
· Accurately decipher charge error reasons and plan follow-up steps.
· Identify all billable services by reviewing all applicable data sources, including, but not limited to, inpatient admits, the client’s practice management system, operative reports, external facility documentation, and procedure reports generated from non-client practice management or electronic medical record systems.
· Review medical record documentation to ensure comprehensive and accurate CPT-4 and ICD-10 codes are entered and posted in the client’s practice management system.
· Abstract codes assigned services, selecting the most appropriate CPT-4 and ICD-10 based on the documentation in the medical record. As necessary, seek clarification from physician or other client healthcare practitioners to clarify services. Ensure all coded services meet appropriate Medicare, NCCI or payer-specific guidelines
· Assist physicians and other health care practitioners with questions regarding coding and documentation guidelines. Provide ongoing feedback based on observations from coding physician/provider documentation
· Review and resolve services that fail charge review edits, coding-related claim edits, and denials due to coding-related issues.
· Follow all department and company policies and procedures.
· Document clear and concise notes within the client’s practice management system to facilitate comprehensive and accurate claim history
· Meet established productivity and quality metrics
· Keep current with payer updates and share knowledge with team and client
· Identify team coding workflow, setup, and training needs
· Participate in monthly and quarterly client meetings
· Ensure the timely and successful delivery of solutions to meet client needs and objectives
Travel
Occassional - less than 5%
Domestic travel to all parts of the US
General Skills/Abilities:
· Professional demeanor
· Excellent communication skills (oral and written)
· Adept at the use of computers and software
· Ability to learn new software quickly without formal training
· Ability to multi-task and handle competing client demands
· Ability to work independently or as part of a team
Problem Solving Skills
· Identify and resolves problem in a timely manner
· Works well in group problem solving situations
· Uses reason even when dealing with emotional topics
· Ability to deliver client-focused solutions based on customer needs
Project Management Skills
- Coordinate projects
- Communicates changes and progress
Technical Skills
- Assess own strengths and weaknesses
- Pursue training and development opportunities
- Strive to continuously build knowledge and skills
- Shares expertise with others
Qualifications
Medical Coding Certification
General surgical, spine orthopedic knowledge a plus
Experience working with an offshore team is a plus
Chart auditing experience is a plus
HCC coding is a plus
Job Type: Full-time
Pay: $50,000.00 - $55,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Paid time off
- Vision insurance
Work setting:
Work Location: Remote