Coder III - Medicare Risk Adjustment

October 3

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Advocate Aurora Health

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Health Care • Hospitals • Outpatient Care • Clinical Trials • Scientific Research

10,000+

💰 $10.2M Grant on 2019-08

Description

• This role will have all responsibilities of coding assistant, coder I and II plus the following: • Assist with special projects as requested. • Assists with training other coders as requested. • Monitor and respond to accounts in the charge router, charge router messages, CRMs, Compliance and Integrity review requests. • Adhere to organizational and internal department policies and procedures to ensure efficient work processes. • Review complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals and hospitals to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. • Assign and ensure correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. • Serve as subject matter expert in your assigned specialty and actively participate in the Coding meetings as a problem solver. • Expertise in query guidelines and coding standards. • Follow up and obtain clarification of inaccurate documentation as appropriate. • Maintain continuing education by attending webinars, reviewing updated CPT assistant guidelines and updated coding clinics. • Knowledgeable in researching coding related topics and issues. • Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines. • Practice ethical judgment in assigning and sequencing codes for proper insurance reimbursement. • Maintain the confidentiality of patient records. • Report any perceived non-compliant practices to the coding leader or compliance officer. • Meet and exceed departmental quality (95% or more) and productivity standards (100%). • Achieve productivity expectations to support discharged not final billed (DNFB).

Requirements

• Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA) • Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge) • Typically requires 5 years of experience in professional coding that includes experiences in professional revenue cycle processes and health information workflows.

Benefits

• Benefits Eligible: Yes • 40 Hours Per Week • First Shift