Presbyterian exists to improve the health of patients, members, and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in New Mexico in 1908. Largest private employer in the state with nearly 14,000 employees, including more than 1600 providers and nearly 4,700 nurses. Health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care), and Commercial health plans.
Remote Multispecialty Pro Fee Coder
Location
United States
Posted
5 days ago
Salary
$22 - $33 / hour
No structured requirement data.
Job Description
Role Description
Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote Multispecialty Pro Fee Coder to join our team.
- Supports the Coding and documentation quality assurance (CDQA) team with minimal supervision.
- Implements and complies with enterprise-wide and department coding policies and procedures for PHS.
- Ensures compliance with all external regulatory agency coding rules and regulations.
- Demonstrates high-level proficiency in performing and/or managing on-site internal audits or reviews.
- Acts as a resource on documentation, coding, billing, and coding compliance questions.
- Works on special coding compliance related projects and develops educational programs.
- Disseminates information to PHS/PMG departments and develops educational tools for compliance.
- Provides support via auditing and training for corrective action plans for coding and audit personnel.
- Performs medical record and billing reviews of denied and appealed claims.
- Coordinates review and tracking of appealed claims and communicates with affected payers.
- Researches and interprets all regulatory agency regulations.
- Liaison to various departments addressing functional coding, auditing, compliance, and training issues.
- Maintains accurate, complete, and timely documentation in electronic or hard copy form.
- Adapts to frequently changing work priorities and schedules.
- Maintains up-to-date technical knowledge of legal and regulatory information.
- Researches coding, billing, and charging compliance issues; recommends and implements corrective action plans.
- Identifies risks, develops action plans, and provides compliance education.
- Assists in the creation of the CDQA Annual Audit Work-plan.
- Exercises independent judgment in determining the reliability of data reviewed.
- Responds to inquiries and requests daily regarding coding and auditing issues.
Qualifications
- High school diploma/GED required.
- Must possess at least one of the following licenses/certifications: RHIT, RHIA, CPC, CCS.
- Minimum of three (3) years experience in coding and/or auditing required.
- Audit experience preferred.
- Excellent written and verbal communication skills.
- Detail and results oriented.
- Ability to work independently and make independent decisions.
- Knowledge of medical terminology, ICD-9, CPT-4, and HCPCS required.
- Proficient knowledge of Medicare, Medicaid, and other third-party payer documentation, coding, and billing regulations.
- Excellent organizational and planning skills.
- Computer skills, especially with Microsoft Word, PowerPoint, and Excel applications.
- Strong written and verbal communication skills to articulate complex regulatory information.
- Personal presence characterized by honesty, integrity, and the ability to inspire and motivate others.
Benefits
- Comprehensive benefits package including medical, dental, vision, short-term and long-term disability, and group term life insurance.
- Optional voluntary benefits.
- Employee Wellness rewards program with opportunities to enhance health and well-being.
Job Requirements
- High school diploma/GED required.
- Must possess at least one of the following licenses/certifications: RHIT, RHIA, CPC, CCS.
- Minimum of three (3) years experience in coding and/or auditing required.
- Audit experience preferred.
- Excellent written and verbal communication skills.
- Detail and results oriented.
- Ability to work independently and make independent decisions.
- Knowledge of medical terminology, ICD-9, CPT-4, and HCPCS required.
- Proficient knowledge of Medicare, Medicaid, and other third-party payer documentation, coding, and billing regulations.
- Excellent organizational and planning skills.
- Computer skills, especially with Microsoft Word, PowerPoint, and Excel applications.
- Strong written and verbal communication skills to articulate complex regulatory information.
- Personal presence characterized by honesty, integrity, and the ability to inspire and motivate others.
Benefits
- Comprehensive benefits package including medical, dental, vision, short-term and long-term disability, and group term life insurance.
- Optional voluntary benefits.
- Employee Wellness rewards program with opportunities to enhance health and well-being.
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