Professional Coder II - Risk Management
Indexed description
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.
- First shift Monday through Friday full time 40 hours per week.
- 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
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 applicable
- Ensure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standards
- Identifythe need forformal clinical queries for documentation clarification when necessary for professionalorfacility records
- Maintain high accuracy and productivity standards appropriate to the complexity of the assigned workload
- Mayprovideinformal guidance to new coding staff on professionalcodingnuances
- An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA);Dual certifications, preferred, specifically CRC
- High School Diploma or Equivalent required
- Completion of an accredited medical coding or HIM program(or equivalentexperience)
- Minimum of 3-5 years of direct professional fee coding experience in a multi-specialty environment isrequired
- Experience with professional procedural coding (e.g., surgical, interventional procedures) is preferred
- Experience with Epic or similar electronic health record systems isrequired
- Proficientknowledge of medical terminology, anatomy, and pathophysiology
- Advancedproficiencyin CPT/HCPCS and ICD-10-CM/PCS coding systems
- Basic understanding of facility payment methodologies (MS-DRGs) as they apply to simple encounters
- Strong analytical skills, attention to detail, and ability to context-switch between different coding guidelines
- Ability to work independently, manage a varied workload, and meet deadlines in a fast-paced environment
- Exposed to normal office environment in a remote work setting
- Job mayrequireoccasional travel for training or meetings, therefore, may be exposed to road and weather hazards
- May 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 day
- Operates all equipment necessary to perform the job
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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.
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