It's more than a career, it's a calling

MO-SSM Health Wool Center

Regular

Job Highlights:

SIGN ON BONUS ELIGIBLE - UP TO $1,000!

Exciting opportunity for a Professional Medical Coder I within SLUCare Physician Group! SLUCare has a wide variety of specialty areas, with over 17 departments, 50+ subspecialties, and 600+ physicians and providers.

Job Summary:

Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow up denials. Works to improve billing based on findings/resolution of errors.
• Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines.
• Performs other duties as assigned.
• Is watchful for charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement.
• Manages assigned charge review, claim edit, and coding follow up work queues.
• Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps.
• Assists physicians/providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding physician/provider documentation. Identifies opportunities for education and communicates trends to leaders.
• Identifies all billable services. Reviews all applicable data sources, including but not limited to, electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs (aka Op Logs), nursing home visit documentation, procedure reports generated from non-the electronic health record systems, etc.
• Consults with physicians/ providers as needed to clarify any documentation in the record that is inadequate, ambiguous, or unclear for coding purposes. Provides education around documentation improvement for maximum patient care.

EDUCATION

• High school diploma or equivalent

EXPERIENCE

Licenses / Certifications:

Certified Coding Associate (CCA) - American Health Information Management Assoc (AHIMA), Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Assoc (AHIMA), Certified Professional Coder (CPC®) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Assoc (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Assoc (AHIMA)

Work Shift:

Employee

9991060235 888315 SLUCare Administration

40

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.