Professional Coder - FT - Day - Physician Professional Coders Remote

Pay Range: $25.49 - $33.16 Scheduled Weekly Hours:40

Position Overview: Responsible for accurately reviewing and assigning Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and ICD-10-CM codes for professional claims billed by Capital Health Medical Group (CHMG) for hospital and outpatient procedures. Accurately applies official coding conventions and rules established by the American Medical Association (AMA) and the Center for Medicare and Medicaid Services (CMS) for assignment of procedural and diagnostic codes. Reviews procedure documentation for accurate assignment of ICD-10-CM diagnosis, current procedural terminology (CPT-4) codes and modifiers. Ensures appropriate coding of evaluation and management services when applicable.

Education: High school diploma or equivalent. Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P) certification required. Associate's degree in health information management preferred.

Experience: Two years' experience in physician coding role preferred. ICD-10-CM, CPT-4 and HCPCS coding experience preferred. One year surgical coding experience preferred. Other Credentials: Knowledge and Skills: Excellent verbal and written communication skills. Strong knowledge of surgical coding guidelines. Knowledge of pathophysiology and disease processes. Special Training: Physician coding and Training certification. Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint. Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge. CPC-A, CPC, or CCS-P required. Mental, Behavioral and Emotional Abilities: Ability to work in environment using multiple EMR systems. Ability to work collaboratively with others as well as independently. Usual Work Day: 8 Hours Reporting Relationships Does this position formally supervise employees? NoIf set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS: Reviews procedure documentation to assign accurate CPT-4 procedure codes and appropriate modifiers for procedures in the operating room, as well as complex procedures performed in a procedure room. Validates provider selected ICD-10-CM diagnosis codes. Analyzes provider documentation to ensure the appropriate provider assigned Evaluation and Management (E&M) codes for the procedural cases. Meets or exceeds departmental accuracy and productivity standards. Ensures compliance with national coding guidelines and Capital Health's policies for complete, accurate and consistent coding resulting in appropriate reimbursement and data integrity. Accurately applies official coding conventions and rules established by the American Medical Association (AMA) and the Center for Medicare and Medicaid Services (CMS) for assignment of procedural and diagnostic codes. Fosters teamwork and collaboration. Reviews CCI edits, MUE edits, LCD and NCD coverage before chart finalization. Identifies documentation gaps or inconsistencies and escalate when clarification is required. Collaborates with billing, charge review, and revenue integrity teams to prevent recurring issues. Addresses professional coding pre-bill edits timely to ensure minimal days in DNFB.Acts as a subject matter expert for professional coding. Performs other duties as assigned.

PHYSICAL DEMANDS AND WORK ENVIRONMENT: Frequent physical demands include:

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Minimal Color Discrimination, Accurate Depth Perception, Accurate Hearing Anticipated Occupational Exposure Risks Include the following: N/AThis position is eligible for the following benefits:

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental PlanVision Plan
• Flexible Spending Account (FSA) - Healthcare FSA - Dependent Care FSARetirement Savings and Investment PlanBasic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance - Voluntary Life Spouse - Voluntary Life Employee - Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity InsuranceVoluntary Identity Theft InsuranceVoluntary Pet Insurance
• Paid Time-Off Program