Provides service line/specialty specific coding/documentation education and feedback related to coding changes to assigned Physicians/APCs. Shares coding/documentation education presentations to Chief Medical Officers, Physicians/APCs, Senior Director Administrators across the organization. Relays any coding changes, feedback, and education to Physician/APC, Locum Tenens, residents/students and/or clinic leadership, as appropriate.

Evaluates health record documentation and charges to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit. Ensures that data complies with regulatory and coding guidelines. Reviews medical information, such as diseases or symptoms and diagnostic descriptions and procedures for a given visit, to accurately assign and sequence the correct ICD-10 CM, HCPCS and CPT codes. Adheres to the quality and productivity standards set by the department.

This is a unique opportunity for someone with a well-rounded skill set, where responsibilities extend beyond those of traditional roles. As a Billing and Coding Specialist, you'll conduct forensic examinations of medical records, provide expert testimony in legal proceedings, and ensure compliance with billing regulations. Stay updated on the latest trends in the field and advise medical teams on compliance requirements.

Seeking an experienced Professional Surgical Coder to code ophthalmology surgical cases performed in both the inpatient and outpatient setting. Qualifications include 3 years’ coding experience and AHIMA or AAPC certification. Technical competency with remote-based connectivity is needed, along with proficiency with office software. A committed regular schedule is required with expectations for reliable and punctual attendance.

The Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. You will interact and communicate effectively with members of the coding team and the appropriate stakeholders, and respond promptly to internal and external customer requests.

Responsible for coding denial follow up work queues and appeals processing for FHPG for multi-speciality providers. The role involves denial and appeals claim processing for medical providers, and laboratories services ordered by FHPB, ensuring compliance and generating appeals for denied or underpaid claims.

Accurately abstract information from the medial records into the appropriate coding systems, ensuring compliance with established guidelines. Determine the most appropriate diagnosis after a thorough review of the medical records. Work closely with practice staff with regards to coding and assignment of a MS-DRGs (Diagnosis Related Group) and APCs (Ambulatory Payment Classification).

The Clinical Coder primarily oversees the coding process for applicable clinical trials. Works with the Safety and Data Management teams to review and code terms per the procedures set forth by RQM+ and sponsors. Facilitates review and coding activities to allow other functional processes to proceed smoothly.

Assumes responsibility for regulatory coding and documentation audit and education activities with providers, clinical and ancillary staff. Performs audit and education duties, acts as primary resource to clinical sections on regulatory coding and related documentation rules and regulation. Provides regulatory coding and documentation education, including developing the Annual Education Plan and coordinating coding education activities in assigned departments.

Under direct supervision, accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. The coder serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. They also analyze, code and abstract complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.