[Hiring] Revenue Cycle Coder @Proliance Surgeons

Role Description

The role of the remote Revenue Cycle Coder is crucial to the revenue cycle team. The team connects with our patients, their insurers or bill payers and our physicians. Accuracy and efficiency of this team directly impacts our mission to be the leader in physician-managed healthcare services and to provide excellent surgical and clinical care for every patient, every day. The Revenue Cycle Coder is critical to maintaining the funding for our services provided.

Prior Orthopedic coding experience is strongly preferred, particularly experience supporting high-volume orthopedic and surgical clinics.

Schedule: Full-time, Monday - Friday, 8am - 5pm PST.

In order to be eligible for hire in a remote position with Proliance, applicants must reside in one of the following States: WA, FL, NC, AZ, ID, OH, OR, TN, TX, or RI.

Key Duties and Responsibilities

• Reviews/audits and interprets medical record documentation to identify pertinent diagnosis/procedure and apply correct ICD10, CPT-4, and HCPC’s codes in accordance with government and insurance regulations.
• Demonstrates appropriate utilization of coding software and coding reference material.
• Follow up with providers on any documentation that is insufficient, missing, or unclear.
• Assists providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders.
• Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines.
• Reviews and resolves suspended charges due to claim edits or payor rejections related to coding.
• Reviews, corrects and appeals coding-related denials trends and shares with leadership, and team members to facilitate root cause analysis and continuous process improvement.
• Corrects and/or appeals denied claims due to coding errors.
• Other duties as assigned.

Qualifications

• Minimum 3 years coding/medical billing experience.
• Professional coder certification with credentialing from AHIMA and/or AAPC, must be maintained annually.
• ICD10 certified and/or extensive work experience.

Knowledge, Skills and Abilities

• Orthopedic coding experience is strongly preferred, particularly experience supporting high-volume orthopedic and surgical clinics.
• A strong understanding of physiology, medical terms, and anatomy.
• Thorough attention to detail.
• Excellent written and verbal communication skills.
• Self-motivated team player able to multi-task and prioritize.
• Excellent organization and interpersonal communication skills.
• Strong computer skills.
• Strong computer skills/experience with Microsoft Excel, Outlook, and Adobe.
• Working experience navigating EHR’s to abstract documentation.

Work Environment/Physical Demands

The remote work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

• Work may be performed in an office and clinical environment.
• Requires corrected vision and hearing to normal range.
• While performing the duties of this job, the associate is regularly required to talk or hear.
• The associate is required to sit for long periods of time, stand and walk, bend and stretch.
• Use of telephone and computer is required.
• Manual dexterity required for use of computer keyboard.
• Occasionally lifts and carries items weighing up to 40 pounds.
• May require working under stressful conditions or working irregular hours.