Certified Coder-ProFee II

Wage Range: $28.26 - $45.23 per hour

Kirkland, WA Campus

Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.

Abstracts, analyzes, and assigns ICD-10-CM, CPT, HCPCS codes and appropriate modifiers for evaluation and management (E/M), minor and major procedures, and diagnostic tests by using either computerized or manual systems. Researches and resolves complex coding and reimbursement issues to ensure the accuracy, quality, and integrity of coding and billing practices. Effectively communicates with physicians, clinic leadership and billing/coding teams regarding documentation improvement opportunities, code changes, and denial trends.

Maintains department defined quality and productivity standards.

• Abstracts, analyzes, and assigns CPT, HCPCS and ICD-10-CM codes for professional services based on documentation in the medical record. Code assignment is primarily for E/M, major procedures and diagnostic tests and based on industry standards and Evergreen Health policies.
• Meets department productivity and accuracy standards.
• Serves as a subject matter resource to physicians for complex surgical procedures.
• Evaluates patient coding inquiries to determine coding accuracy based on documentation in the patient’s medical record.
• Promotes a positive working relationship by effectively communicating with clinic managers regarding changes in the provider’s CPT code selection.
• Evaluates and researches coding denials from payers to determine the appropriate action and drafts appeal letters regarding complex surgical procedures and bundling issues for Denial Management.
• Identifies and reports trends of code changes, payer denials, missed revenue opportunities and/or compliance risks to clinic leadership.
• Identifies and communicates documentation improvement opportunities to physicians and clinic leadership.
• Provides coverage and backup for other coders as necessary to meet organizational goals.

• Abstracts, analyzes, and assigns CPT, HCPCS and ICD-10-CM codes for professional services based on documentation in the medical record. Code assignment is primarily for E/M, minor procedures and diagnostic tests and based on industry standards and Evergreen Health policies.
• Promotes a positive working relationship by effectively communicating with clinicians and other support staff regarding changes in the provider’s CPT code selection.
• Evaluates and researches coding denials from payers to determine the appropriate action and drafts appeal letters for Denial Management.
• Identifies and reports trends of code changes, payer denials, missed revenue opportunities and/or compliance risks to the Professional Coding Supervisor.
• Identifies and communicates documentation improvement opportunities to Professional Coding Supervisor.
• Performs other duties as assigned.

• High school diploma or G.E.D
• Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist‑Physician [CCS‑P], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT]), Certified Coding Associate CCA
• Minimum three years of coding experience with one year of coding experience in a surgical practice, or one year of coding experience and current AAPC specialty surgical certification as outlined below.
• Satisfactory completion of general and specialty specific coding skills assessment
• Proficient knowledge of medical terminology, ICD‑10‑CM, CPT, and HCPCS coding conventions.
• Comprehensive knowledge of anatomy, physiology, and disease processes.
• Expanded…