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:

Scheduled Weekly Hours:

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 Maintains level of expertise through continuing education.

Performs other duties as assigned.

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 15 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.