Professional Coder IV, Anesthesia

Professional Coder IV

Position Highlights: 

• Shift Schedule: Full Time (40 hours), Monday-Friday
• Department: Anesthesia
• Location:  Atrium Health Wake Forest Baptist 

What We Offer: 

• Generous PTO: Accrue up to 25 days/year, to be used for vacations, sickness, holidays, and personal matters.
• Education Reimbursement: We invest in your professional growth, offering up to $2,500 per year towards a bachelor’s degree and up to $5,000 per year towards a graduate degree.
• Wellness Incentives: Take advantage of up to $1,350 per year in wellness incentives through our LiveWELL program, prioritizing your well-being.
• Parental Benefits: We understand the importance of family, providing six weeks of paid birthing-mother maternity leave and four weeks of paid parental leave.
• Retirement: Secure your financial future with up to 7% employer-paid retirement contributions.

What You'll Do: This position is responsible for lead coder tasks, including but not limited to assisting the coding manager with productivity and quality reporting, special projects, coder work allocation, new employee training and quality audits, and researching and responding to questions and concerns from coding employees. Responsible for assignment and review of ICD, CPT and HCPCS codes in the WakeOne health information system. Ensures that professional services are substantiated by codes and provider documentation. Responsible for auditing ICD, CPT and HCPCS codes and identifying and/or assisting in resolution of inconsistencies or data quality issues. Audit and problem-solving activities may require frequent and close collaboration with multiple areas of the organization including providers, facility coding, internal and external auditors and Finance. 

1. Works collaboratively with coding manager in process management/improvement. 

2. Assists coding manager with team productivity and quality audit reporting. 

3. Researches and responds to questions from team coders. 

4. Codes records maintaining established departmental accuracy and productivity standards. 

5. Identifies, assigns and appropriately sequences accurate diagnoses, procedural, and E/M codes. Applies correct ICD, CPT and HCPCS guidelines and regulatory requirements as per departmental policy regarding compliant methods, timeframes, productivity and quality standards, and use of applications. 

6. Assists in demonstrating medical necessity for procedures and services performed by ensuring that all documented disease processes are coded. 

7. Abides by the AAPC Code of Ethics and/or the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines. 

8. Reviews and/or edits ICD, CPT and HCPCS codes that substantiate providers professional services for inpatient or ambulatory health records including ambulatory, ancillary and OR surgery, emergent and urgent care, observation, and clinic records and other work as assigned, maintaining established departmental accuracy and productivity standards. Data reported is used to meet licensure requirements, statistical purposes, and for financial and billing purposes. 

9. Reviews and/or edits professional services to reflect accurately provider documentation according to regulatory, payer, and professional guidelines. 

10. Applies necessary coding guidelines to permit claims processing in charge review, coding denial and/or claim edit work queues. 

11. Resolves moderately-significantly complex coding and billing issues, and resolves pending charges in the WakeOne coding work queues assigned. 

12. Functions at an expert coder level and participates in auditing, training, and re-training of coders as directed. 

13. Interfaces with other departments as needed and provides excellent customer service. 

14. Participates in on site and/or external training workshops as opportunities arise. 

15. Maintains credentials, if applicable, and submits written evidence of maintenance. 

16. Performs other related duties as requested by Manager. 

What You'll Need:

• Graduation from an accredited medical coding program 
• Three years' experience in a professional coding setting; or an equivalent combination of education and experience. 
• One year multiple specialty and/or patient type coding experience preferred. 
• Epic Super User training preferred and required within 12 months of hire. 
• General knowledge of anatomy and physiology and medical terminology required with completion of college level courses preferred. 
• Medical coding certification is required through AAPC, AHIMA or other professional coding societies