Coder III, Professional Srvcs

Overview

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At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, leadership programs
• And more

Description

JOB DESCRIPTION:

• This position is accountable for reviewing physician documentation, CPT, HCPCS & ICD10-CM coding. FRONT END CODER: The primary focus of this position will be Advanced Surgical and Interventional Procedures. This position is accountable for the performance of charge capture, including TES edit maintenance and resolution, denial prevention, and go to contact for special projects in order to optimize the revenue potential for the department. Revenue cycle responsibilities include daily functions that contribute to service capture, charge capture (Evaluation & Management expert), management of patient financial information (registration/insurance, referrals, pre-certs etc.), and collection of patient service revenue. Assignments will focus on the most complex and high risk procedures/cases with a strong understanding of anatomy and physiology as well as coverage across multiple specialties. Additional functions include: mentoring those in Coder I and Coder II roles; dividing time between coding, auditing (presenting and defending findings), internal training and external physician education and onboarding; assisting in cross training the coding team and fostering existing/new physician relationships. This role should be an expert in both E&M and procedure coding and be knowledgeable about several related specialties.
• They must be able to represent coding guidelines (specifically as applicable to the pod) at a high level and participate in proactive revenue issue resolution. The Coder III should be able to work independently and maintain a high level of compliance and quality. This role is often seen as the go to coder for projects and is regularly engaged to enhance charge capture across the whole team. This role will foster collaboration among other coders on the team and providers. The Coder III will be able to maintain all assigned tasks and keep all metrics in expected thresholds. This position reports to the Supervisor or Manager, Revenue Cycle Operations. Employee may be responsible for other duties as assigned. MINIMUM QUALIFICATIONS: A High School Diploma or equivalent; coding certificate through nationally recognized organization (AAPC, AHIMA, etc.) required: CCS-P, CPC, RHIA, RHIT, CCS, CPC-H; and an additional specialty certification. Three years professional coding experience in CPT, HCPCS, and ICD10-CM; two years of experience must be in an outpatient specialty or Surgical/Ancillary Diagnostic discipline. Preferred working knowledge includes: medical terminology, anatomy and physiology, GE Centricity experience, billing regulations, insurance coverage limitations, managed care protocols, the ability to research unfamiliar procedures and services, Computer Assisted Coding (CAC), introduction to research, Medicare guidelines and billing requirements, medical devices, professional medical society websites, NCCI edit conventions. A mandatory training program based on skill set is required upon hire. Completion of the internal CDP program is preferred. PHYSICAL REQUIREMENTS: 1-10 lbs 0-33% of the work day (occasionally), negligible 34-66% of the workday (frequently), negligible 67-100% of the workday (constantly). Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste. chemicals/gases/fumes/vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting patient care/handling injuries, radiation, shift work, travel may be required, use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Additional Details

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week''s advance notice is preferred.