Professional CDI Specialist - 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:

Scheduled Weekly Hours:

Position Overview

SUMMARY (Basic Purpose of the Job)

Facilitates compliant physician coding and documentation for accurate assignment of diagnosis, Evaluation and Management and Current Procedural Terminology codes. Performs ongoing audits on medical record for accurate assignment and to ensure all industry guidelines, laws and regulations are met. Performs physician education on proper documentation to support code selections. Identifies and reports coding errors to Physician Fee Supervisor to review and respond. Reviews and responds to all denials as well as requests for records.

MINIMUM REQUIREMENTS

Education: High School Diploma, Associates degree in Health Information Management preferred. Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P) required. Physician coding and Training certification.
Experience: Three years experience in physician coding role. Auditing experience preferred. Outpatient ICD 9/10, CPT, CM, and HCPCS coding experience.
Other Credentials:
Knowledge and Skills: Excellent verbal and written communication skills. Knowledge of pathophysiology and disease processes. Strong knowledge of industry guidelines and laws for physician coding and reimbursement. Possesses research and analysis skills.
Special Training: Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint or Access. Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge. Ability to develop, implement and deliver, and assess coding education plans using a variety of methods to individual providers or provider groups.
Mental, Behavioral and Emotional Abilities: Ability to learn and develop auditing and education skills to perform physician education. 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

Audits medical record documentation for accurate assignment of diagnosis, current procedural terminology, and evaluation and management codes. Research coding and reimbursement issues and reports findings to management, physicians, and staff.
Provides ongoing education to physicians, and LIP's on documentation requirments for accurate code assignments. Works with supervisor for any training related questions.
Performs internal quality assessment reviews on physician (professional) coding to ensure compliance with national coding guidelines and Capital Health's policies for complete, accurate and consistent coding which results in appropriate reimbursement ad data integrity.
Assists with preparation and presentation of monitoring results for review with physicians and hospital leadership.
Attends hospital and medical staff meetings to respond to documentation related issues. Provides support for coding provider-based billing related claims, this includes coding professional fees.
Facilitates change processes required to capture needed documentation such as forms design.
Assists in appeals process resulting from third party reviews.
Maintains level of expertise through continuing education. Maintains appropriate productivity levels.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include:

Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion , Taste or Smell , Talk or Hear

Continuous physical demands include: Sitting

Lifting Floor to Waist 10 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Minimal Color Discrimination, Accurate Depth Perception, Accurate Hearing
Anticipated Occupational Exposure Risks Include the following: N/A

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

- Healthcare FSA

- Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

- Voluntary Life Spouse

- Voluntary Life Employee

- Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.