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Job Details

Edit Coder

Company name
TH Medical.

Location
Des Moines, IA, United States

Employment Type
Full-Time

Industry
Healthcare

Posted on
Jan 13,2020

Valid Through
Apr 27,2020

Apply for this job






Profile

Edit Coder','!*!

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!

 

JOB SUMMARY

This

position will be functioning under minimal supervision and utilizing

independent decision making.  This

position is to problem solve and complete edits with consistency and

efficiency. The Edit Coder will investigate and solve edit issues and communicate

root cause data to management to solve problems upstream and downstream. 

 

Responsible

for modifying and completing moderate to high complexity coding and charging

edits/errors 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.  Working in Bill

Scrubber systems a requirement.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

Performs

data quality reviews on outpatient encounters to validate the ICD-10-CM, CPT,

and HCPCS Level II code and modifier assignments, APC group appropriateness,

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. Assists in the development of such criteria as needed.

Monitors facility CRC reports for prebill edits related to APC.  Addresses CCI and LCD edits within the

various billing scrubbers while abiding by the Standards of Ethical Coding as

set forth by the American Health Information Management Association. Meets

and/or exceeds Conifer’s APC specialist productivity standards.Reviews

claim denials in comparison with medical records for the determination of

accurate 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

inpatient and outpatient unbilled accounts report for outstanding and/or

uncoded outpatient encounters to reduce accounts receivable days for

outpatients. Brings identified issues to department managers for

resolution. ','!*!

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.

Advanced

personal computing skills including MS Outlook, MS Word, MS ExcelAdvanced

technical skills required to learn and navigate a variety of software systems,

trouble-shoot computer problems, install periodic updates to software programs

and work efficiently in a virtual environmentStrong

written and verbal communication skillsAbility

to think/work independently, yet interact positively with teamAdvanced

problem-solving skills and ability to quickly analyze a situation.Attention

to detail is crucial to this position.  Other

functions as deemed necessary to complete and final bill claims accurately

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 skillsKnowledge

of medical terminology, anatomy and physiology, disease process,  and surgical procedures

CERTIFICATES, LICENSES, REGISTRATIONS

RHIA,

RHIT or CCS preferred but not required.

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 completing

assessments and analysisIncludes

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.

Characteristic

of typical office environment requiring use of desk, chair, and office

equipment such as computer, telephone, printer, etc.Work

environment is at a moderate noise level.

OTHER

Professional

appearance and demeanor','Conifer Health Solutions','IA-Des Moines','','','Full-time','Full-time','Days','Days','','','','','','','2005001271','Edit Coder

Company info

TH Medical.
Website : http://www.tenethealth.com

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