Certified Coder-ProFee II

Primary Job Duties

• Abstracts, analyzes, and assigns CPT, HCPCS and ICD-10-CM codes for professional services based on documentation in the medical record.
• Code assignment is primarily for E/M, major procedures and diagnostic tests and based on industry standards and EvergreenHealth policies.
• Maintains department defined quality and productivity standards.
• Serves as a subject matter resource to physicians for complex surgical procedures.
• Evaluates patient coding inquiries to determine coding accuracy based on documentation in the patient’s medical record.
• Promotes a positive working relationship by effectively communicating with clinic managers regarding changes in the provider’s CPT code selection.
• Evaluates and researches coding denials from payers to determine the appropriate action and drafts appeal letters regarding complex surgical procedures and bundling issues for Denial Management.
• Identifies and reports trends of code changes, payer denials, missed revenue opportunities and/or compliance risks to clinic leadership.
• Identifies and communicates documentation improvement opportunities to physicians and clinic leadership.
• Provides coverage and backup for other coders as necessary to meet organizational goals.

Qualifications

• REQUIRED for the position: High school diploma or G.E.D.
• Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT]), Certified Coding Associate CCA
• Minimum three years of coding experience with one year of coding experience in a surgical practice, or one year of coding experience and current AAPC specialty surgical certification as outlined below.
• Satisfactory completion of general and specialty specific coding skills assessment
• Expanded understanding of payer billing requirements
• Excellent written and verbal communication skills
• Must possess or achieve one of the following AAPC specialty surgical certification(s) within one year from hire or transfer into the position: (Certified Cardiology Coder [CCC], Certified Coding Associate [CCA], Certified Cardiovascular and Thoracic Surgery Coder [CCVTC], Certified Gastroenterology Coder [CGIC], Certified General Surgery Coder [CGSC], Certified Interventional Radiology Cardiovascular Coder [CIRCC], Certified Obstetrics Gynecology Coder [COBGC], Certified Ophthalmology Coder [COPC], Certified Orthopedic Surgery Coder [COSC], Certified Urology Coder [CUC])

Benefits

• Medical, vision and dental insurance
• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retail plans 457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits
• Cafeteria & Gift Shop Discount