[Hiring] Facility Coder - Certified @Confluence Health

Role Description

This position has the option to work virtually. Must reside in the state of WA, OR, ID, WI, FL, MT, TX, AZ, VA, TN.

The Certified Facility Coder will be responsible for:

• Reviewing all medical record information to extract data and apply appropriate diagnoses and procedure codes for billing, internal and external reporting, research, and regulatory compliance.
• Accurately coding conditions and procedures as documented in the Official Guidelines for Coding and Reporting for Hospital Departments.
• Acting as a coding resource for team members and medical staff, ensuring compliance with ICD-10CM/PCS, CPT & HCPCS according to AMA and CMS.
• Assigning codes utilizing an electronic encoder application in accordance with practice policy and regulatory guidelines.

Qualifications

• High School Diploma or equivalent GED.
• Minimum 1 year coding experience or equivalent education/experience.
• Knowledge of ICD-10, CPT coding, medical terminology, anatomy, and insurance billing.
• Understanding of DRG’s for Inpatient Facility coding positions.
• Possesses basic computer skills (e.g., spreadsheets, word processing).
• One of the following coding certifications: CPC (CPC-A), CIC, COC (COC-A) from AAPC or CCA, CCS, CCS-P, RHIA, RHIT from AHIMA.

Requirements

• Facility coders are responsible for coding: Inpatient, Ambulatory, Observation, Emergency Department, Interventional Radiology, Radiology, Outpatient OB, Outpatient Therapy, and/or Infusions.
• Ability to extract and assign ICD-10CM/PCS, CPT, Modifiers and HCPCS codes per coding guidelines.
• Inpatient diagnoses and procedures shall be coded in accordance with UHDDS definitions.
• Understanding/assign DRG’s, MC’s and CCs for Inpatient Facility Coding.
• Reviews accounts and charges in EPIC.
• Review and adjust coding for Part A/B rebilling.
• Ability to research Coding Clinics.
• Reviewing medications to apply appropriate infusion administration charges.
• Assists with coding audits from payor and RAC audits providing rebuttal letters if needed.
• Codes all records based on documentation, following coding guidelines, payer regulations and ethics.
• Demonstrate knowledge of CMS Hierarchical Condition Category (HCC) Risk Adjustment coding.
• Apply knowledge of coding rules, review and resolve CCI/LCD/NCD’s and modifier edits.
• Effectively uses software and/or coding books to verify coding accuracy.
• Responsible to stay current with billing guidelines and reimbursement rules and regulations.
• Work with Revenue Integrity & Compliance on audits and coding questions.
• Contribute as a team member with Clinical Documentation Specialists.
• Provides feedback to providers using authorized methods as directed by department policy.
• Works with clinical staff to resolve coding issues and related problems.
• Participates in educational activities as requested.
• Maintain department coding production standards for assigned specialties.
• May be requested to perform job tasks not specifically related to primary assignments.
• Performs other duties as assigned.
• Demonstrate standards of behavior and adhere to the Code of Conduct in all aspects of job performance.

Benefits

• Retirement Plan
• Pool Differential
• Sick Leave
• Shift Differential
• Employee Assistance Program