Coder III

About the role

Join our collaborative team at the Paley Orthopedic & Spine Institute, where every day brings new opportunities to make a meaningful impact on patient well-being through patient-centered care. This role focuses on coordinating, performing, and completing Medicare compliance for coding outpatient and inpatient services, including procedures, while ensuring adherence to NCQA, regulatory agencies, and Tenet policies.

Responsibilities

• Performs all assigned billing in a timely manner.
• Communicates with physicians regarding documentation needed to complete job functions.
• Ensures accurate coding from the medical record for ICD-9, ICD-10, and appropriate evaluation and management CPT codes.
• Updates patient records with current insurance, address, and telephone numbers.
• Identifies primary care doctor and referral source, documenting contact information in the medical record.
• Performs claims follow-up and reviews with the billing agent in a timely manner.
• Protects patient confidentiality according to HIPAA guidelines.
• Maintains proper credentials and researches coding issues to ensure correct coding per CMS guidelines.
• Identifies and attends one course/conference per specialty, per year, to continue education in the coding field.

Requirements

• AA Degree required; Bachelor’s Degree preferred.
• 5 years of coding experience required.
• Healthcare background required.
• Proficiency in CPT, ICD-10, ICD-9, CPT-4, and HCPCS required.
• Knowledge of coding schemes and reimbursement practices required.
• RHIA, RHIT, CCS, CPC, or COC certification required.
• Proficiency in Microsoft Office and Excel required.
• Willingness to be flexible and adaptable in a complex, matrix environment.

Benefits

• Medical, dental, vision, and life insurance.
• 401(k) retirement savings plan with employer match.
• Generous paid time off.
• Career development and continuing education opportunities.
• Health savings accounts, healthcare, and dependent flexible spending accounts.
• Employee Assistance Program.
• Employee discount program.
• Voluntary benefits, including pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder and childcare, auto, and home insurance.

Note: Eligibility for benefits may vary by location and is determined by employment status.