Physician Coder II - Remote

Erlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY

Position is responsible for coding of physician and/or mid-level provider professional services. Recognize and complete a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follow set procedures to achieve goals. Display professional office skills and ability to navigate a practice management system. Good written and oral communication skills, ability to handle multiple tasks, and work with and train other employees.

Ability to serve as liaison between management, the physician practices, and employees working within physician practices.

This position is involved in a team-based approach to care. Team members are trained to meet the highest level of function for their role as per the State of Tennessee/Georgia guidelines.

Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent Care, ED, or a variety of other specialties.

Services can include all visit types for a coder 1, plus office procedures, bedside procedures, and procedures using conscious sedation.

• Provide various components of coding services to support our providers.
• Review and analyze information available in the electronic medical record and/or paper record to accurately code the episode of care in multiple specialty areas.
• Calculate Pro Fee and/or Facility E/M levels by following the AMA guidelines for E/M assignment.
• Recognize critical care cases by patient acuity.
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available.
• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, CPT, and HCPCS
• Interpret coding guidelines for accurate code assignment
• Responsibility to maintain an understanding of National Correct Coding Initiatives, Local Coverage Documents, and MUE’s.
• Responsibility to maintain understanding and apply Medicare Teaching Physician Guidelines.
• Applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.
• Review and correct EPIC coder claim edits and eValuator edits as needed.
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.
• Align conduct with AHIMA's Standards of Ethical Coding and the Company's Code of Ethics and Business Conduct and support the Company's Ethics and Compliance Program.
• Adherence to Det Norske Veritas (DNV) and other third-party documentation guidelines in an effort to minimize risk.
• Continually improve coding quality and accuracy.
• Responsibility for maintaining coding certification and knowledge referencing current ICD-10-CM and CPT coding guidelines and regulatory changes.
• Contacts the appropriate department or physician office for assistance in obtaining physician clarification of diagnoses CPT and/or HCPCS.
• Communicates with physician and non-physician providers to resolve conflicting provider documentation to further specify coding of diagnoses, surgeries and procedures documented in the medical record.
• Resolves payer denials and responds to inquiries from revenue cycle teams, and processing of charge corrections as appropriate.
• Provides ongoing feedback to physicians and other providers during charge review.
• Comply with all internal policies and procedures.
• Actively participate in Company provided training and education.
• Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.
• This position must consistently meet or exceed productivity and quality standards as defined by department Leadership.

• Knowledge of Anatomy and Physiology, Disease Pathology, and Medical Terminology.
• Knowledge of basic coding conventions and…