Job Description
Job Description:
This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, CPT/HCPCS procedure codes, and modifiers to ensure proper reimbursement for complex professional services. Requires extensive knowledge and understanding of ICD-10-CM and CPT/HCPCS coding guidelines, medical terminology, and disease processes. Works closely with clinicians, 1st/2nd/3rd year residents and operations to ensure complete and accurate documentation, coding, and charges for the professional services provided. Adheres to the quality and productivity standards set by the department.
Education Qualifications:
Key Responsibilities:
Evaluates health record documentation and charges to ensure proper reimbursement and clinicians' RVUs by ensuring that ICD-10-CM diagnostic and CPT/HCPCS procedural codes, and modifiers accurately reflect and support the professional encounter
Identifies documentation clarification opportunities to ensure that documentation supports the coding and charges for the services provided. Initiates coding queries and provides feedback to clinicians
Reviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided
Works with the coding denials team for education and assists with denial prevention solutions
Ensures professional encounters are coded accurately and in a timely manner
Consistently maintains coding quality (95% accuracy) and productivity expectations
Assists with the training of professional coders
Performs related duties as required
Educational Requirements:
Required Qualifications:
Preferred Qualifications:
Epic experience
3M Encoder experience
Licensure/Certification Qualifications:
Certification/Licensure Requirements:
Current certification with American Health Information Management Association (AHIMA) or AAPC and credentialed as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), and/or Certified Coding Specialist-Physician-Based (CCS-P)
Specialty certification, i.e., Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiation Oncology Certified Coder (ROCC), etc. required within two (2) years if coding a specialty that requires a special certification
Job Location: Duluth Family Medicine Clinic
Shift Rotation: Day Rotation (United States of America)
Shift Start/End: Days/Days
Hours Per Pay Period: 80
Compensation Range: $21.91 - $32.87 / hour
Union:
FTE: 1
Weekends:
Call Obligations:
Sign On Bonus:
Equal Employment Opportunity (EEO) at Essentia
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.
