Performs the same duties as Medical Coder I and II – Hosp IP and Medical Coder I, II, III – Hosp OP, but also serves as a resource for Medical Coders (IP and OP) when needed on complex application of codes. Participates in and mentors coders, provides problem resolution and feedback to supervisors. Assists and serves as back-up to the Medical Coder Auditor – Hosp IP &OP as needed on completing PWC SMART coding edits.
This is a remote position eligible for hire from: Arizona, Florida, Georgia, Iowa, Kentucky, Maryland, Michigan, Mississippi, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, West Virginia, and Wisconsin.
1. Assigns and/or audits International Classification of Diseases 10-CM (ICD-10) diagnostic and ICD-10-PCS procedural codes, Current Procedural Terminology (CPT) codes with modifiers, and other applicable codes in an accurate and productive manner on inpatient, outpatient (observation, ambulatory surgery, and ancillary cases).
2. Queries providers when documentation is conflicting, needs clarification and specificity.
3. Groups codes and completed product into payment group.
4. Analyzes information for optimal and proper reimbursement.
5. Ensures compliance with all appropriate coding, billing and data collection regulations and procedures.
6. Reviews work of staff as needed. Responds to questions and refers staff as appropriate to the Medical Coder Auditor.
7. Researches and resolves problems from coders as needed.
8. Provides input on performance of coders to supervisor for performance evaluations.
9. Performs coding audits at a minimum of two medical coders per month as needed to back up the Medical Coder Auditors – Hosp IP/OP.
10. Researches and resolves problems referred by coders in response to audited charts. Provides information on performance of coders’ audits to supervisors.
11. Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
12. Provides training and serves as a general resource to assist other coders and members of department staff.
13. Reviews, analyzes and abstracts physician/other documentation for diagnoses, procedures, ancillary testing, medications, laboratory and other services provided. Communicates with physicians and other health care staff to obtain missing information or to clarify existing information.
14. Reviews and processes PWC SMART edits.
15. Utilizes a variety of software (e.g. EPIC, Optum CAC, PWC SMART, etc.) to compile and validate medical information.
● Associate’s degree in Health Information Management, Nursing or related field or an equivalent combination of education, training, and experience.
● Successful completion of the UNC HCS Inpatient and Outpatient Coder Proficiency Test.
● Must have one of the following: – AHIMA (American Health Information Management Association) certification and credential – AAPC (American Academy of Professional Coders) certification and credential
Professional Experience Requirements:
● If Associate’s degree: Three (3) years of experience in Inpatient and Outpatient hospital coding.
● If High School Diploma: Seven (7) years of experience in Inpatient and Outpatient hospital coding.
Knowledge/Skills/and Abilities Requirements:
● Strong knowledge of ICD-10/PCS/CPT/HCPCS coding with excellent analytical and data mining skills. Ability to effectively manage projects, plan and implement programs, and evaluate outcomes. Ability to effectively work with direct various levels of staff (including on-site and remote) and mentoring colleagues. Must possess strong communication skills, both written and verbal and have extensive attention to detail. Exhibits effective organizational skills, time management, and management of multiple priorities. Ability to interpret complex medical conditions and work with complex coding applications. Ability to have an excellent balance of being highly productive and yet produce high quality work. Ability to interpret federal and state regulations as they relate to coding and compliance.
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: HIM Hospital Coding
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.
Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
UNC Health makes reasonable accommodations for applicants’ and employees’ religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email firstname.lastname@example.org if you need a reasonable accommodation to search and/or to apply for a career opportunity.
To apply for this job please visit jobs.unchealthcare.org.