Senior Professional Coder - FT - Day - Physician Professional Coders Remote

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

$28.70 - $37.32

Scheduled Weekly Hours:

40

Position Overview

Responsible for performing highly complex CPT, HCPCS, and ICD-10-CM coding for professional claims billed by Capital Health Medical Group (CHMG) for hospital and outpatient procedures. Provides expert-level coding, supports provider documentation improvement, resolves complex billing issues, conducts coding reviews of staff, and serves as a resource and mentor to coding staff. Provides assistance and support to the manager as it relates to time management, delegation of workflow tasks and responsibilities, knowledge of industry guidelines, laws and regulations. Reviews procedure documentation for accurate assignment of ICD-10-CM diagnosis, current procedural terminology (CPT-4) codes and modifiers. Ensures appropriate coding of evaluation and management (E&M) services when applicable.

MINIMUM REQUIREMENTS
Education:    High school diploma or equivalent. Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P) certification required. Associate's degree in health information management preferred.
Experience:    Three years' experience in physician coding role with surgical coding experience required using ICD-10-CM, CPT-4 and HCPCS.
Other Credentials:    
Knowledge and Skills:    Excellent verbal and written communication skills. Strong knowledge of surgical coding guidelines. Knowledge of pathophysiology and disease processes.
Special Training:    Physician coding and Training certification. Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint. Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge. CPC, or CCS-P required.
Mental, Behavioral and Emotional Abilities:    Ability to work in environment using multiple EMR systems. Ability to work collaboratively with others as well as independently.
Usual Work Day:    8 Hours  
Reporting Relationships
Does this position formally supervise employees? No

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS
Assists in management of professional coding team workflow to assure timely and efficient coding.
Provides second level scrutiny of procedural documentation as well as code assignment to optimal and compliant coding.
Shares expertise in professional coding with team members to resolve complex coding issues and build skill level and proficiency.
Conducts internal coding reviews to ensure accuracy, compliance, and documentation sufficiency.
Contacts and collaborates with appropriate personnel for documentation insufficiencies to expedite resolution of accounts.
Meets or exceeds departmental accuracy and productivity standards. Fosters teamwork and collaboration.
Collaborates with CHMG providers to explain coding requirements and documentation standards.
Ensures compliance with national coding guidelines and Capital Health's policies for complete, accurate and consistent coding resulting in appropriate reimbursement and data integrity.
Performs coding duties and reviews CCI edits, MUE edits, LCD and NCD coverage before chart finalization.
Assists with onboarding, training, and mentoring of new staff.
Supports system upgrades, coding tool enhancements, EMR changes, and new specialty rollouts.
Assists in management of professional coding pre-bill edits timely to ensure minimal days in DNFB.
Supports continuous process improvement efforts to enhance coding outcomes Maintai