Tenet Healthcare

Senior Coder

Tenet Healthcare

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇺🇸 United States

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Salary

💰 $25 - $37 per hour

Job Level

Senior

About the role

  • This position will be functioning under minimal supervision while utilizing independent decision making.
  • The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts.
  • Responsible for modifying and completing moderate to high complexity reviewing and resolving coding and charge edits 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 billing editor systems as required.
  • Performs claim edit reviews on outpatient encounters to validate appropriateness of the CPT codes, HCPCS Level II codes, and 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. Assists in the development of such criteria as needed. Addresses CCI and LCD edits within the various billing editors while abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
  • Meets and/or exceeds Conifer’s Edit Coder productivity standards.
  • Runs and submits coding operational reports to leadership as requested, reviews data and identifies opportunities or trends. Demonstrates working knowledge of DNFB and uses data to drive performance excellence. Ability to analyze, display, and communicate data in meaningful manner. Ability to maneuver thru various electronic systems effectively.
  • Ability to deal with customer/partner issues and resolve conflict. Ability to multi-task and meet deadlines. Will act as a resource for Edit Coders.
  • Reviews claim denials and utilizes the medical record in determining accurate code assignment of all documented diagnoses and procedures adhering to the standards of ethical coding.
  • Monitors DNFB report for outstanding and/or uncoded encounters to ensure timeliness of coding completion. Brings identified issues to department managers for resolution.

Requirements

  • Three years minimum hospital outpatient coding/edit experience
  • 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, 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.
  • Comprehensive knowledge of ICD-10 and CPT coding systems.
  • Strong knowledge base of changes in LCDs and NCDs.
  • Strong knowledge base of current NCCI and OCE guidelines
  • Attention to detail is critical to this position
  • Other functions as deemed necessary to complete and final bill claims accurately
Benefits
  • 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.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
ICD-10-CMCPTHCPCScoding rulescoding regulationsbilling editor systemsDNFBNCCI guidelinesOCE guidelinesAPC mandates
Soft skills
independent decision makingproblem-solvingwritten communicationverbal communicationattention to detailmulti-taskingconflict resolutionteam interactiondata analysisperformance excellence
Certifications
AHIMA Standards of Ethical Coding