Facility ED Coder

Join our team as a Facility ED Coder! Role responsibilities include assessing documentation for each service rendered in the hospitals place of service in order to accurately code principal diagnoses (i.e. preponderance of care sequence) secondary conditions procedures and social determinant codes using American Hospital Association guidelines Current Procedural Terminology guidelines payer specific rules for commercial and/or Medicaid insurance and drug administration for specified service lines impacting Floridas enhanced ambulatory grouping. This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges)working knowledge of revenue codes relevant grouper function and financial impact; assessment and entry of surgical charges (i.e. supplies implants) and pharmacy charges (i.e. contrast patient supplied etc).

This position is remote. Applicants must reside in one of the following states:Alabama Colorado Delaware the District of Columbia Florida Georgia Illinois Maryland Missouri New Jersey New York North Carolina Ohio Pennsylvania South Carolina Tennessee Texas and Virginia.

Responsibilities:

1. Ability to comprehend medical record documentation to accurately assign codes for both concurrent and discharged accounts across multiple specialties.
2. Meets minimum requirements for production and quality monthly.
3. Requires a working knowledge of code sequencing for grouper-related payers with attention to detail to avoid rework and waste with charge capture assessment component.
4. Requires understanding and application ofM.E.A.T. criteria (i.e. monitoring evaluation assessment treatment) using ICD 10 CM transaction data set to capture diagnoses.
5. Analyzes high-risk encounters for accurate and/or missing charges gaps prior to encounter completion (i.e. missing charges from anesthesia surgery) when manual charge capture occurs.
6. Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce take backs associated with un-clear or un-substantiated care rendered. (i.e. varyingmodifier assignment for EAPG vs. Non-EAPG payer specificity)
7. Requires excellent coding knowledge of ICD 10 CM CPT 4 and modifier application with expectations to maintain certification (i.e. CCS CPC RHIT or RHIA) and apply ICD 10 CM Coding Guidelines specific to both inpatient and outpatient encounters.
8. Facilitate modifications to clinical documentation through query interaction to ensure that the information captured supports the level of service rendered with attention towards chronic conditions hierarchical condition categories (HCC) and risk adjustment factors (RAF).
9. Demonstrates an excellent working knowledge of hospital information systems to retrieve data specific information (i.e. order diagnosis patient type) within a complicated filing schema including non-hospital data (i.e. Media Tab Office Visits etc)

Qualifications:

1. Minimum education of an Associates degree required
2. Medical Terminology Anatomy and Physiology required
3. One of the following certifications required: CPC CCS RHIT RHIA COC (please include on resume)

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