[Hiring] Ambulatory Professional Fee and Hospitalist Coder @NorthBay Health

Role Description

At Northbay Health, the Coder will play a crucial role in accurately translating medical procedures and diagnoses into ICD 10, CPT and HCPCS codes in an accurate and timely manner in the hospital setting. Our ideal candidate is a dedicated, knowledgeable individual with a strong understanding of medical terminology, coding guidelines, regulations, and proficiency in utilizing an EHR/encoder system.

• Effectively communicate with providers via email, query, phone call or in person to educate or discuss coding requirements.
• Abstract demographic and physician data to meet both internal and regulatory requirements for reporting utilizing the hospital’s abstracting system.
• Perform coding of patients’ inpatient records to ensure accurate assignment of physician, professional fee, surgical, and other hospital-based services.
• Add modifiers as appropriate to maximize reimbursement and reduce denials.
• Collect visit information, analyze documentation, identify discrepancies, and query providers as needed.
• Utilize the electronic health record (EHR), abstracting systems, encoding systems, and computer-assisted coding systems.
• Ensure coding is accurate and sequenced correctly in compliance with coding guidelines, government regulations, and payer requirements.
• Maintain current knowledge of coding requirements and compliance guidelines based on assigned specialty and departmental needs.
• Meet department productivity and quality standards for coding performance.
• Provide documentation education and support to physicians to ensure coding assignments comply with regulatory requirements.
• Collaborate with the Clinical Documentation Integrity (CDI) program as needed.
• Respond to audit reviews and address findings in a timely manner.
• Provide timely feedback to the Manager, Professional Fee Coding, regarding operational issues.
• Partner with Business Office staff to resolve billing and coding issues.
• Keep management and applicable departments informed regarding completed work and other assigned responsibilities.
• Maintain required coding certification and pursue ongoing professional development.
• Adhere to HIPAA policies and procedures to maintain patient confidentiality.
• Comply with organizational policies and procedures, safety standards, and all applicable regulatory requirements.
• Demonstrate the True North Values of Nurture/Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence.
• Report to the office as required and understand that failure to meet regulatory accuracy standards may result in a return to an in-office work environment.
• Perform other duties and responsibilities as assigned.

Qualifications

• High School Graduate or equivalent preferred.
• Certified Professional Coder (CPC), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
• Five or more years of continuous experience in Multi-specialty Profee Hospital and clinical coding required.
• EMR Medical records experience is required.
• Experience with an encoder system preferred.
• Comprehensive knowledge and application of profee E&M guidelines for physician inpatient coding and billing.
• Demonstrated knowledge of anatomy and physiology, medical terminology, disease process, reimbursement methodologies (DRGs, HCCs, APCs), and the conventions, rules and guidelines for current coding classification (ICD10-CM, CPT and HCPCS).
• Demonstrated understanding of the clinical content of a health record.
• Knowledge of and experience with PC’s, Cerner, and/or computer systems and programs highly desired.
• Microsoft Office: Email, Word, Excel.
• Has a comprehensive understanding of insurance requirements and compliance guidelines for Medicare, PHP, WHA and Medi-Cal, Worker’s Compensation, Commercial Insurances.
• Ability and self-discipline to be able to work remotely.
• Ability to withstand the pressure of continual deadlines and receipt of work with variable requirements.
• The ability to work independently as well as in a team environment.

Requirements

• Ability and desire to hit metrics upon training.
• Technically savvy (ability to learn software and troubleshoot equipment as needed).
• Attendance is an essential function of the job.
• Ability to sit for long periods of time.
• Ability to lift, push or pull 5 pounds.
• Occasional bending, stooping, crouching, reaching.
• Ability to concentrate and maintain accuracy despite frequent interruptions.
• Keyboarding skills.

Benefits

• Comprehensive benefits package including medical, dental, and vision insurance.
• Life, disability, and long-term care coverage.
• Paid time off including vacation, sick leave, holidays, and bereavement.
• 403(b) retirement plan with employer match.
• Education reimbursement for eligible roles.
• Professional development and training programs.
• Employee Assistance Program and wellness programs.
• Recognition programs and shift differentials.
• Market-based compensation review and increases subject to approval and organizational performance.