Remote Edit Coder

Mommy Jobs Online (https://mommyjobsonline.com) is now seeking for someone to fill the position of a Remote Edit Coder to work in the U.S. only.

JOB TYPE: Full-time

DESCRIPTION:

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. Abstracting required clinical information from the medical record. Working in Bill Scrubber systems is a requirement.

ESSENTIAL FUNCTIONS:

• Perform 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.
• Monitor the medical visit code selection by departments against facility specific criteria for appropriateness. Assist in the development of such criteria as needed. Monitor facility CRC reports for prebill edits related to APC. Address 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. Meet and/or exceed APC specialist productivity standards.
• Review 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: Stay 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. Stay current with the CMS’s annually updated National Correct Coding Initiative Coding Policy Manual, CMS coding and billing regulations, MUE, and OCE.
• Monitor inpatient and outpatient unbilled accounts report for any outstanding and/or uncoded outpatient encounters to reduce accounts receivable days for outpatients. Bring identified issues to the department managers for resolution.
• Other functions as deemed necessary to complete and final bill claims accurately

QUALIFICATIONS

MUST be a U.S. citizen. High school diploma or equivalent.

CERTIFICATES: RHIA, RHIT or CCS  is preferred but is not required.

SKILLS:

• 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
• Advanced personal computing skills including MS Outlook, MS Word, MS Excel
• Advanced 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 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 crucial to this position.

JOB REQUIREMENTS: Computer, Internet, and a home office set-up.

PAYMENT: $18.00-$25.00 per hour

TO BECOME A MEMBER:

Please visit https://mommyjobsonline.com and click on Join Now. You will then need to select the Medical Coding Remote Job Bank Registry to become a lifetime member and to get connected with this client to begin their hiring process.  Please email us your resume after you register with your qualifications and work history.

Please reference agent ID code MJOLCarolH on your registration submission.

Mommy Jobs Online is accepting pre-screening interviews, so please call (405) 418-6160 and ask for Kimberly.

Jobseeker Live Chat:  https://tawk.to/chat/5bd13d86476c2f239ff5dd42/default

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. Abstracting required clinical information from the medical record. Working in Bill Scrubber systems is a requirement.

ESSENTIAL FUNCTIONS:

• Perform 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.
• Monitor the medical visit code selection by departments against facility specific criteria for appropriateness. Assist in the development of such criteria as needed. Monitor facility CRC reports for prebill edits related to APC. Address 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. Meet and/or exceed APC specialist productivity standards.
• Review 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: Stay 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. Stay current with the CMS’s annually updated National Correct Coding Initiative Coding Policy Manual, CMS coding and billing regulations, MUE, and OCE.
• Monitor inpatient and outpatient unbilled accounts report for any outstanding and/or uncoded outpatient encounters to reduce accounts receivable days for outpatients. Bring identified issues to the department managers for resolution.
• Other functions as deemed necessary to complete and final bill claims accurately

MUST be a U.S. citizen. High school diploma or equivalent.

CERTIFICATES: RHIA, RHIT or CCS is preferred but is not required.

SKILLS:

• 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
• Advanced personal computing skills including MS Outlook, MS Word, MS Excel
• Advanced 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 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 crucial to this position.

JOB REQUIREMENTS: Computer, Internet, and a home office set-up.