Join Providence as a Senior Coder assigning DRGs, APCs, ICD - 10, and CPT codes. Responsible for inpatient, outpatient, and observation coding according to guidelines.
About the role
- Medical Records Coder reviewing coding accuracy per guidelines and resolving insurance coding denials. Ensuring accurate reimbursement and collaborating with internal and external sources for documentation clarity.
Responsibilities
- Reviews codes for accuracy in accordance with coding rules and policies
- Responsible for system edit reviews and follows up on insurance coding denials for resolution
- Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation
- Completes system edit reviews to make corrections before transmittal
- Troubleshoots problems that prevent claims from being released
- Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem
- Provides feedback for correction and follow-up
- May abstract data and review codes for accuracy
- Ensures accurate reimbursement based on guidelines and/or abstraction of provider documentation
- Responds to coding information requests and inquiries from various sources
- Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete
Requirements
- High School diploma or equivalent
- 1 year Medical Coder experience required
- Associate's degree preferred
- Knowledge of ICD-10CM, CPT and HCPSC required
- Working knowledge of medical terminology and anatomy required
- American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred
- Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute preferred
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
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