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Emory Healthcare/Emory University Coder II, Professional Srvcs Full-Time 8a-4:30p (Northlake) in Atlanta, Georgia

Description

JOB DESCRIPTION:

  • This position is accountable for reviewing physician documentation, CPT, HCPCS & ICD10-CM coding.

  • FRONT END CODER: This position is accountable for the performance of charge capture, TES edit maintenance and resolution, denial prevention, and special projects in order to optimize the revenue potential for the department.

  • Coder should be a near expert in E&M coding, could be asked to provide cross coverage over other similar specialties, and participates in the onboarding/training of Coder I.

  • Revenue cycle responsibilities include daily functions that contribute to service capture, charge capture (procedure coding and Evaluation & Management expert), management of patient financial information (registration/insurance, referrals, pre-certs, etc.), and collection of patient service revenue.

  • This role will serve as a mentor for Coder Is as well as a coding resource to provide cross coverage during times of need.

  • This role will be involved in targeted audits (presenting and defending findings), regular interaction with the physicians and other clinical providers as needed.

  • This coder should be able to build successful working relationships with assigned providers.

  • This position reports to the Supervisor or Manager, Revenue Cycle Operations.

  • Employee may be responsible for other duties as assigned.

  • CODING DENIALS SPECIALIST: The primary focus of this position will be to review and resolve all daily coding related denials based on coding/billing guidelines.

  • The job role is accountable for edit maintenance and resolution, Denial resolution, charge correction and special projects in order to optimize the revenue collections for the Department.

  • Research and resolve all outstanding coding related denials with work queues/coding specialties and complete all necessary follow-up within a timely and accurate manner.

  • The job role is responsible for communicating all denial trends and denial increases directly to supervisor/manager in order to positively affect the volume of denials.

  • This position reports to the Supervisor or Manager, Coding Denials Management.

  • Employee may be responsible for other duties as assigned.

MINIMUM QUALIFICATIONS:

  • High school diploma or equivalent.

  • Coding certificate through nationally recognized organization (AAPC, AHIMA, etc.) required: CCS-P, CPC, RHIA, RHIT, CCS.

  • Two (2) years of professional coding experience in CPT, HCPCS and ICD10-CM.

  • Coding certification in an outpatient specialty, preferred.

  • Completion of the internal CDP program is preferred.

  • Working knowledge of medical terminology, anatomy, and physiology.

  • GE Centricity experience preferred.

  • Knowledge of modifiers and appropriate application.

  • Working knowledge of billing regulations, insurance coverage limitations, and managed care.

  • Preferred knowledge includes: Introduction to research, Medicare guidelines and billing requirements, medical devices, professional medical society websites, and NCCI edit conventions.

PHYSICAL REQUIREMENTS: 1-10 lbs 0-33% of the work day (occasionally), negligible 34-66% of the workday (frequently), negligible 67-100% of the workday (constantly). Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste. chemicals/gases/fumes/vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting patient care/handling injuries, radiation, shift work, travel may be required, use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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Division Emory Healthcare Inc.

Campus Location Atlanta, GA, 30345

Campus Location US-GA-Atlanta

Department EHI PGP PFS Denials Unit

Job Type Regular Full-Time

Job Number 90398

Job Category Revenue Cycle & Managed Care

Schedule 8a-4:30p

Standard Hours 40 Hours

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

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