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Remote Profee coder

Profee Coder II - preferred experience in IV Radiology - CIRCC preferred

JOB PURPOSE:

Responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of discrepancies/trends, resolving edits and denials, and releasing encounters for billing. Utilizes intermediate problem-solving skills to address coding related tasks of detailed, medium complexity. Duties include procedural (CPT) and diagnosis (ICD-10) coding for all places of service, including, but not limited to ER, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services. Responsible for reviewing, analyzing, and interpreting physician documentation, CPT and diagnosis coding, charge entry, coding claim edit, and coding denial management for coding related tasks. Monitors medical records to ensure documentation complies with hospital and payer policies and regulations. Educate physicians on proper documentation techniques and improvement opportunities. Maintains working knowledge of payer specific coding guidelines, medical terminology, modifier usage, and NCCI edit conventions, as well as healthcare billing and reimbursement guidelines. Ability to translate operative notes into billable services.

MINIMUM EDUCATION REQUIRED:

High School Diploma/GED required. Coding Certificate program, AAPC or AHIMA accredited preferred.

MINIMUM EXPERIENCE REQUIRED:

Two (2) years of coding experience required Working knowledge of medical terminology, anatomy, and physiology. Proficiency with Microsoft Office. Preferred Qualifications: Knowledge of EPIC EeMR. Strong analytic skills. Computer Assisted Coding (CAC) knowledge.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:

None

ADDITIONAL PREFERRED QUALIFICATIONS:

CPC, CCS, CPC-H, CCS-P, CCS-H, RHIA, RHIT, or equivalent coding certification required.

KEY RESPONSIBILITIES:



1. Codes office, hospital inpatient, outpatient, medical, diagnostic, procedural, emergency room and/or recurring records within established productivity coding accuracy guidelines.

2. Evaluates medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the visit.

3. Assigning and sequencing codes accurately based on medical record documentation

4. Assigning the appropriate discharge disposition as necessary.

5. Evaluates records and prepares reports of appropriate production metrics and coding feedback and maintains or exceeds established productivity and coding accuracy standards. May monitor unbilled accounts.

6. Queries physicians when code assignments are not straightforward or documentation is inadequate, ambiguous, or unclear for coding purposes; offers physician opportunity to submit corrected documentation.

7. Notifies appropriate individuals of potential non-compliance with medical necessity requirements and when services are non-covered or not payable, as appropriate.

8. Corrects failed claim errors to billing edits, and other coding related errors.

9. Documents coding information and takes appropriate actions in the Practice Management System in accordance with the department's policies and procedures.

10. Maintain the knowledge necessary to navigate the EeMR to efficiently perform tasks and meet production and quality standards. Works independently to resolve issues, applying root cause analyses to determine steps required for timely resolution.

11. Provides technical guidance to physicians and other departmental staff in identifying and resolving issues or errors.

12. Develops effective working relationships with physicians and other stakeholders. The ability to communicate effectively and professionally in interactions with physicians, management, and staff. Must be able to work collaboratively and positively within a culturally diverse production environment.

13. Maintains professional growth by participating in educational programs and professional organization to stay abreast of code changes, trends, practices, and developments. Must meet all requirements to maintain coding certification

14. Performs other duties as assigned.

KNOWLEDGE, SKILLS, ABILITIES

· Knowledge of ICD-9-CM/ICD-10-CM and CPT coding principles and guidelines.

· Knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system.

· Knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to medical documentations, billing and coding.

· Knowledge of Standards of Ethical Coding.

· Skill and ability to communicate effectively both orally and in writing.

· Skill and ability to research and analyze data, draw conclusions, and resolve issues.

· Skill and ability to read, interpret, and apply policies, procedures, laws, and regulations; read and interpret medical procedures and terminology; develop training materials; make group presentations; exercise independent judgment; and prepare reports and related documents.

· Skill and ability to maintain working relationships with physicians and other staff.

Benefits

Becoming an AMN Healthcare nurse gives you the incredible opportunity to explore new cities, gain critical nursing career experience, and earn a highly competitive salary-but the perks don't stop there. There are many additional benefits to enjoy through travel nursing jobs, including:

  • Premium health benefits for you and your family
  • Access to the largest network of facilities and providers in the country
  • Industry-leading clinical team support
  • Licensure assistance
  • 401k matching
  • Free CEUs



About the Company

At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

Remote Profee coder

Atlanta, GA
Full Time

Published on 06/29/2022

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