Edit Coder - Remote

JOB SUMMARY

This position will be functioning under moderate supervision while utilizing independent decision making. This position is to problem solve and complete outpatient account with consistency and efficiency. The Edit Coder will investigate and solve outpatient coding issues and communicate root cause data to management in order to mitigate potential upstream and downstream impacts.

Responsible for modifying and completing moderate to high complexity, reviewing and resolving outpatient accounts using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Performs account reviews on outpatient encounters to validate appropriateness of the CPT codes, HCPCS Level II codes, modifier assignments, APC group appropriateness, review for missed secondary diagnoses and/or procedures, and ensure compliance with all APC mandates and outpatient reporting requirements. Monitors medical visit code selection by departments against facility specific criteria for appropriateness. Meets and/or exceeds Conifer’s Edit Coder productivity standards.
• Reviews denials and utilizes the medical record in determining accurate code assignment of all documented diagnoses and procedures adhering to the standards of ethical coding.
• Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM/PCS, ICD-10 initiatives, and CPT/HCPCS coding.
• Stays current with CMS annually updated National Correct Coding Initiative Coding Policy Manual, CMS coding and billing regulations, MUE and OCE.
• Monitors DNFB report for outstanding and/or uncoded encounters to ensure timeliness of coding completion. Brings identified issues to department managers for resolution.
• Strong attention to detail and proficient with computer skills and knowledge of EHRs.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Experience with MS Outlook, MS Word, MS Excel
• Possess technical skills required to learn and navigate a variety of software systems, trouble-shoot computer problems and work efficiently in a virtual environment
• Strong written and verbal communication skills
• Ability to think/work independently, yet interact positively with team
• Advanced problem-solving skills and ability to quickly analyze a situation.
• Attention to detail is critical to this position.
• Other functions as deemed necessary to complete and final bill claims accurately

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience required to perform the job.

• Outstanding interpersonal communication skills as well as excellent oral and written communication skills
• Knowledge of medical terminology, anatomy and physiology, disease process, and surgical procedures

CERTIFICATES, LICENSES, REGISTRATIONS

• Required: AHIMA RHIT or RHIA or AAPC CCS, CPC approved credential

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to lift 15-20lbs
• Ability to sit and work at a computer for a prolonged period of time
• Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Office/Hospital Work Environment
• Works in a private office space in the coder’s home per Conifer Telecommuter Policy as defined in the Telecommuting Program Guide

OTHER

• Must be able to travel nationally as needed, not to exceed 10%

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Compensation and Benefit Information

Compensation

• Pay: $20.51-$30.77 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.