Professional Coder II - Risk Management

Department 13497 Enterprise Revenue Cycle - Coding Production Operations: Professional Coding Operations Medical and Primary Status Full time Benefits Eligible Yes Hours Per Week 40 Schedule Details/Additional Information Will support: Risk Management and prefer the 3+ years’ experience to be in Risk Management Coding. Schedule First shift Monday through Friday full time 40 hours per week. Certification Required Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).Preferred Certification: CRC Remote Opportunity Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range $26.55 - $39.85 Major Responsibilities Independently perform complex, specialty-specific professional fee coding (CPT/HCPCS and ICD-10-CM) for physician servicesrenderedin both office and hospital settings, ensuring expert application of modifiers and E/M guidelines, or;Perform entry-level facility coding for simple outpatient encounters (e.g., diagnostic imaging, labs) and basic inpatient services (e.g., uncomplicated admissions, short stays) using ICD-10-CM and ICD-10-PCS,where applicableEnsure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standardsIdentifythe need forformal clinical queries for documentation clarification when necessary for professionalorfacility recordsMaintain high accuracy and productivity standards appropriate to the complexity of the assigned workloadMayprovideinformal guidance to new coding staff on professionalcodingnuances Licensure, Registration, And/or Certification Required An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA);Dual certifications, preferred, specifically CRC Education Required High School Diploma or Equivalent requiredCompletion of an accredited medical coding or HIM program(or equivalentexperience) Experience Required Minimum of 3-5 years of direct professional fee coding experience in a multi-specialty environment isrequiredExperience with professional procedural coding (e.g., surgical, interventional procedures) is preferredExperience with Epic or similar electronic health record systems isrequired Knowledge, Skills & Abilities Required Proficientknowledge of medical terminology, anatomy, and pathophysiologyAdvancedproficiencyin CPT/HCPCS and ICD-10-CM/PCS coding systemsBasic understanding of facility payment methodologies (MS-DRGs) as they apply to simple encountersStrong analytical skills, attention to detail, and ability to context-switch between different coding guidelinesAbility to work independently, manage a varied workload, and meet deadlines in a fast-paced environment Physical Requirements And Working Conditions Exposed to normal office environment in a remote work settingJob mayrequireoccasional travel for training or meetings, therefore, may be exposed to road and weather hazardsMay need to be able tolift upto 40 lbs. occasionally (e.g., equipment)Sitsthe majority ofthe workday, but also may lift, reach, and bend throughout the dayOperates all equipment necessary to perform the job This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. #REMOTE Our CommitmenttoYou Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or trainingPremium pay such as shift, on call, and more based on a teammate's jobIncentive pay for select positionsOpportunity for annual increases based on performance Benefits And More Paid Time Off programsHealth and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term DisabilityFlexible Spending Accounts for eligible health care and dependent care expensesFamily benefits such as adoption assistance and paid parental leaveDefined contribution retirement plans with employer match and other financial wellness programsEducational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits. Responsible for the validation and/or abstraction coding of routine office to off-premise patient visits, including inpatient and outpatient procedures for all billable clinicians, ensuring that claims are submitted to insurance payers in the most compliant, efficient and expeditious manner possible. This position is accountable for accurate abstracting of selected clinical and non-clinical information to create a comprehensive database of information for billing purposes, internal data management, and external reporting of data.