Orthopaedic Medical Coder
Medical Coder Job 46 miles from Miamisburg
Full-time Description
General Job Summary: Contributes in the delivery of excellent orthopaedic care in a patient centered environment by completing data entry and coding for all premier orthopaedic care provided within the multi-specialty practice.
Essential Job Functions:
1. Establishes and maintains effective working relationships with coworkers, managers and providers.
2. Collects, reviews, codes, and data entry of all charges for a multi-specialty practice.
3. Responsible for quality control of all billable charges according to the coding compliance plan.
4. Maintains current records of hospital admissions, surgeries, discharges, and consultations as necessary.
5. Maintains required billing records, reports, files, etc.
6. Responsible for educating providers regarding charges.
7. Responsible for contributing to claims corrections and appeals.
8. Provides accurate coding information to all pertinent departments.
9. Maintains doctor's standards according to coding compliance.
10. Ensure certification is current.
11. Ensure HIPAA compliance.
12. Establish and maintain effective working relationships with patients, providers, and co-workers.
13. Takes initiative in performing additional tasks that may be necessary or in the best interest of the practice.
Requirements
Education/Experience:
High school diploma.
Associates degree in a related field is preferred.
Coding certification (CPC-A or CPC) through AAPC or a (CCA or CCS) through AHIMA is required.
Other Requirements: Schedules will change as department needs change including overtime, evenings and weekends. Travel as needed.
Performance Requirements:
Knowledge:
Knowledge of the Companies Mission, Vision and Values.
Knowledge of coding and clinic rules, guidelines, compliance, and operating policies.
Knowledge of anatomy and medical terminology.
Knowledge of and stays currents on all coding guidelines and updates.
Knowledge of billing practices and clinic policies and procedures.
Knowledge electronic health records and practice management systems.
Knowledge of HIPAA guidelines.
Skills:
Excellent organizational, multi-tasking and adaptability skills.
Detail oriented.
Basic math skills.
Abilities:
Ability to understand and interpret policies and procedures.
Ability to read and interpret medical charts.
Ability to examine documents for accuracy and completeness.
Ability to maintain productivity set forth by leadership, while ensuring accuracy.
Ability to communicate effectively and work with others.
Ability to maintain a 93% accuracy rate.
Equipment Operated: Standard office equipment.
Work Environment: Office environment.
Required Mental/Physical Demands: Sitting about 90% in front of a computer screen. Fast paced high productivity environment. Must be able to remain focused and attentive without distractions (i.e. personal devices).
Coding Specialist II
Medical Coder Job 39 miles from Miamisburg
This position abstract codes provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Provides coding expertise to department management, coding staff, clinical staff, and billing staff. Meets or exceeds departmental standard related to quality and productivity
Job Requirements:
Associate's Degree
Equivalent experience accepted in lieu of degree
CPC, CCS-P, CCM, RHIA, RHIT, CCA
Extensive knowledge of ICD-10-CM and CPT coding Methodologies
Abstract coding of inpatient and outpatient medical records
Extensive knowledge of medical terminology and Anatomy
3-4 years experience in a related field
Job Responsibilities:
Other job-related information:
Current professional coding credential:
AAPC (Certified Professional Coder [CPC]
Certified Outpatient Coder [COC])
PMI (Certified Medical Coder [CMC])
AHIMA (Certified Coding Specialist-Physician [CCS-P]
Certified Coding Specialist [CCS]
Registered Health Information Administrator [RHIA]
Registered Health Information Technician [RHIT])
Working Conditions:
Climbing - Rarely
Concentrating - Consistently
Continuous Learning - Consistently
Hearing: Conversation - Frequently
Hearing: Other Sounds - Frequently
Interpersonal Communication - Consistently
Kneeling - Rarely
Lifting
Lifting 50+ Lbs - Rarely
Lifting 11-50 Lbs - Rarely
Pulling - Rarely
Pushing - Rarely
Reaching - Rarely
Reading - Consistently
Sitting - Frequently
Standing - Occasionally
Stooping - Rarely
Talking - Frequently
Thinking/Reasoning - Consistently
Use of Hands - Consistently
Color Vision - Frequently
Visual Acuity: Far - Frequently
Visual Acuity: Near - Frequently
Walking - Occasionally
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:
Serve: ALWAYS…
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS…
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS…
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS…
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS…
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community
Coding Specialist II
Medical Coder Job 34 miles from Miamisburg
This position abstract codes provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Provides coding expertise to department management, coding staff, clinical staff, and billing staff. Meets or exceeds departmental standard related to quality and productivity
Job Requirements:
Associate's Degree
Equivalent experience accepted in lieu of degree
CPC, CCS-P, CCM, RHIA, RHIT, CCA
Extensive knowledge of ICD-10-CM and CPT coding Methodologies
Abstract coding of inpatient and outpatient medical records
Extensive knowledge of medical terminology and Anatomy
3-4 years experience in a related field
Job Responsibilities:
Other job-related information:
Current professional coding credential:
AAPC (Certified Professional Coder [CPC]
Certified Outpatient Coder [COC])
PMI (Certified Medical Coder [CMC])
AHIMA (Certified Coding Specialist-Physician [CCS-P]
Certified Coding Specialist [CCS]
Registered Health Information Administrator [RHIA]
Registered Health Information Technician [RHIT])
Working Conditions:
Climbing - Rarely
Concentrating - Consistently
Continuous Learning - Consistently
Hearing: Conversation - Frequently
Hearing: Other Sounds - Frequently
Interpersonal Communication - Consistently
Kneeling - Rarely
Lifting
Lifting 50+ Lbs - Rarely
Lifting 11-50 Lbs - Rarely
Pulling - Rarely
Pushing - Rarely
Reaching - Rarely
Reading - Consistently
Sitting - Frequently
Standing - Occasionally
Stooping - Rarely
Talking - Frequently
Thinking/Reasoning - Consistently
Use of Hands - Consistently
Color Vision - Frequently
Visual Acuity: Far - Frequently
Visual Acuity: Near - Frequently
Walking - Occasionally
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:
Serve: ALWAYS…
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS…
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS…
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS…
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS…
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community
Coder I
Medical Coder Job 39 miles from Miamisburg
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.
UC Health is committed to providing an inclusive, equitable and diverse place of employment.
Using established policies and procedures; the Non-certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Non-certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set.
Coding quality:
Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG's.
* Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation.
* Maintains an acceptable coding accuracy rating on records assigned.
* Queries physicians when necessary to ensure documentation supports the codes assigned.
Coding productivity:
* Performs coding on medical records in an efficient manner meeting productivity standards and assisting the department in meeting and maintaining its goals.
* Completes productivity data correctly and timely.
Billing edits, coding corrections, DRG changes:
* Reviews, researches, and resolves claim edits for billing purposes.
* Reviews records following feedback from payers, auditors and managers and makes corrections to coding, disposition and/or DRG assignment when indicated.
Accountability:
* Reviews educational materials thoroughly and takes responsibility for applying this information when coding.
* Seeks to clarify information and educational material when necessary.
* Listens actively.
* Maintains information and resources in an organized manner so that information can be referenced easily.
* Reviews emails timely and thoroughly and responds when indicated.
* Manages the remote work setting effectively and comes on site when system, connectivity or other issues arise that would impact work performance.
Minimum Required: High School Diploma or GED. Formal education in basic ICD-9CM/CPT coding, Medical Terminology, Anatomy/, pathophysiology and disease processes. Preferred: Associate's OR Bachelor's Degree in healthcare related field. | Preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS). | Minimum Required: 1 year of Acute Care Coding.
IP Coder Certified - HIMS IP Coding - Miamisburg - FT/Days
Medical Coder Job In Miamisburg, OH
Incentives Sign On Bonus! Up to $5k available for eligible applicants Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Campus Overview
Kettering Health Miamisburg
* Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
* Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
* The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
* Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
* 142 bed facility
* Awarded with 100 Top Hospital by IBM Watson Health for the 10th time in 2019.
* In 2020, KH Miamisburg received an "A" from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
* Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
* KH Miamisburg received several awards from Healthgrades:
* Outstanding Patient Experience Award (2017-2019)
* America's 100 Best Hospitals for Prostate Surgery Award (2020)
* Joint Replacement Excellence Award (2020)
Responsibilities & Requirements
Responsibilities:
* Strong written and verbal communication skills.
* Proficient in data entry, personal computers, knowledge of medical terminology, anatomy and physiology and disease processes.
* Knowledge and experience with 3M and Epic clinical data system preferred.
* Consistently follow coding guidelines and uses coding references to accurately select the appropriate principal diagnosis and procedure as well as secondary diagnoses and procedures.
* Evaluates the quality of documentation of all accounts to identify incomplete or inconsistent documentation which affects coding, abstracting and charging and handles appropriately.
* Identifies and monitors charging errors to reduce loss of revenue and any other issues regarding correct coding and reimbursement.
* Coordinates and performs activities associated with processing and correcting rejected accounts.
* Demonstrates knowledge of and adherence to department coding policies and compliance plan.
* Maintains certification and demonstrates up-to-date job knowledge.
Preferred Qualifications
Requirements:
* Associate or Bachelors' degree in Health Information Management with RHIT or RHIA certification and/or CCS certification.
* RHIT/RHIA eligible will also be considered with coding/abstracting experience preferred (must sit for the exam at first available offering after completion of RHIT/RHIT program including passing their certification exam within one year of the first attempt.One to two years coding/abstracting experience in an acute care hospital with RHIT or RHIA certification or three to five years coding/abstracting experience in an acute care hospital with CCS certification.[Ohio, United States] OtherRHIT, RHIA, CCS
Clinical Coding Specialist
Medical Coder Job 45 miles from Miamisburg
Engage with us for your next career opportunity. Right Here.
Job Type:
Regular
Scheduled Hours:
24 This position processes medical records by coding, abstracting data, and producing information for third party billing and to provide a complete statistical database.
Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.
Job Description:
Reviews inpatient or observation, same day surgery, and interventional procedure records or emergency department or complex ancillary records. Identifies and codes principal and secondary diagnoses and principal and secondary procedures in appropriate sequence so that the accurate DRG/APC will be assigned according to Official Coding Guidelines to provide information for billing purposes. Meets department coding standards for quality and productivity of 96%. (New staff are expected to meet these standards upon completion of the training period).
Assigns all codes based on documentation. Participates in corporate compliance program. Upholds the highest ethical standards.
Abstracts demographic and medical information into computer system following departmental guidelines to provide an accurate data base for statistical reference.
Communicates with Corporate Coding Manager, Coding Team Leader, CDI Specialists, Patient Accounts staff and fellow coders in a professional manner as needed regarding held accounts, coding changes, coding questions, physician queries, rebills, etc.
Completes various reports such as productivity reports, statistical reports and log sheets in order to maintain an accurate source of reference material and other documentation. Performs daily or weekly follow-up of all dates assigned and submits updates accordingly.
Attends educational programs and applies knowledge to enhance job performance. Uses resources available for accurate coding (i.e., Coding Clinic and CPT Assistant).
Performs other duties as assigned.
Education, Credentials, Licenses:
Associate or Bachelor's degree (or equivalent hospital based coding experience)
CCS, CPC-H, RHIT, or RHIA credentials
Physician coding credentials of CCS-P and CPC are not preferred but recognized for coding other than inpatient.
An apprentice credential is not sufficient.
Specialized Knowledge:
Medical Terminology, Anatomy and Physiology
ICD/CPT experience Prospective Payment Systems, Outpatient Medical Necessity.
Use of personal computer
Kind and Length of Experience:
Two to Four years hospital coding experience
DESIRABLE
Encoder experience; Clinical Documentation experience; CAC (Computer Assisted Coding) experience.
FLSA Status:
Non-Exempt
Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community.
SURGICAL CODER - PPC
Medical Coder Job 5 miles from Miamisburg
Centralized Billing Office FT / 80 hours per pay The Surgical Coder works to ensure timely, accurate, and compliant coding of physician services for the purpose of maximizing reimbursement within current payer guidelines. This position is part of a centralized billing office and provides both procedural, E/M, and ICD-10 coding services for the multi-specialty practices within Premier Physician Network.
Nature and Scope
The Surgical Coder is responsible for reviewing chart documentation within the scope defined by CBO leadership, for the purpose of extracting appropriate procedural, E/M, and ICD-10 codes, to best represent provider services performed and documented. This position is specialty based and requires expanded knowledge of various functions within the coding and billing process. The Surgical Coder is expected to interact with PPN providers for the purpose of enhancing physician engagement and confidence by providing feedback and education as requested.
Qualifications
1. High School diploma or equivalency certificate.
2. Minimum 2-3 years of previous healthcare coding experience required; AAPC or AHIMA coding certification preferred.
3. Knowledgeable about third party billing regulations and CPT/ICD coding.
4. Proficient computer and data entry skills.
5. Effective problem-solving skills and ability to work independently.
6. Working knowledge of spreadsheet applications.
7. Proven record of dependability.
8. Effective verbal and written communication skills.
9. Detail Oriented and ability to appropriately prioritize work.
10. Effective time-management skills.
Medical Records Coordinator II (Must live in Wisconsin)
Medical Coder Job 11 miles from Miamisburg
The Medical Records Coordinator II is responsible for all forms and aspects of retrospective medical record retrieval including, but not limited to, claims data analysis, outreach data research, direct EMR retrieval, Requests of Information (ROI) deployment, pend-record resolution, medical record audits, attestation capture, and report documentation. This position is remote and there will be travel within the state of WI for records retrieval.
Essential Functions:
Execute the request, retrieval, and pend resolution of medical records through various channels
Utilize custom and SFTP portals to facilitate PHI data transfer
When needed provide personal information necessary to gain access to health network systems
Collaborate with health systems and provider offices to execute, and document their process for release of information requests
Update operational databases, and provide context by documenting commentary
Navigate and properly escalate obstacles to medical record retrieval
Support and implement process improvements with external and internal partners
Utilize the MS Office Suite including, but not limited to MS Teams, Office, Excel, Outlook, and Word to facilitate record retrieval and execute mail merges
Verify retrieved medical records' accuracy
Partner across CareSource's department matrix to address operational needs
Support and maintain medical record repository
Manage provider practice and health network relations to minimize provider abrasion
Populate chase specific reports to drive and reflect the execution of risk adjustment programs
Support and refine implementation of risk adjustment processes across all lines of business
Research claims data to produce information optimized for chart retrieval
Reconcile retrieval related invoices
Perform any other job duties as requested
Education and Experience:
High School Diploma or equivalent required
Minimum one (1) year healthcare experience preferred
Minimum one (1) year medical records experience preferred
Competencies, Knowledge and Skills:
Intermediate proficiency in the Microsoft Office Suite
Verbal and written communication skills
Ability to work independently and within a team environment
Attention to detail
Critical listening and thinking skills
Time management skills
Proper phone etiquette
Data analysis
Business analysis
Project management
Customer service oriented
Brand ambassadorship
Decision making/problem solving skills
Takes initiative to research and resolve obstacles
Must be able to self-direct work when given a goal/task
Licensure and Certification:
None
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
May be required to travel
Compensation Range:
$35,200.00 - $56,200.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Hourly
Organization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
Medical Records Specialist
Medical Coder Job 39 miles from Miamisburg
Gastro Health is seeking a Full-Time Medical Records Specialist to join our team!
Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours.
This role offers:
A great
work/life balance!
No weekends or evenings -- Monday thru Friday
Paid holidays and paid time off
Rapidly growing team with opportunities for advancement
Competitive compensation
Benefits package
Here are some of the duties you will be responsible for:
Scans reports
Medical records and billing encounter forms in EMR system
Opens and distributes mail accordingly throughout the office
Manages medical record requests from patients
Insurance companies or medical facilities and completes them in a timely manner
Handles medical record preparation for standard audits from insurance companies
Minimum Requirements:
High school diploma or GED equivalent
One year experience working in medical practice or similar settings
Medical terminology
Ability to multi-task
Attention to detail
Familiar with HIPAA standards
Organization
Able to work independently and keep up with the workflow
Able to multi-task and cross cover at the Front Desk
We offer a comprehensive benefits package to our eligible employees:,
401(k) retirement plans with employer Safe Harbor Non-Elective Contributions of 3%
Discretionary Profit-Sharing Contributions of up to 4%
Health insurance
Employer Contributions to HSA's and HRA's
Dental insurance
Vision insurance
Flexible Spending Accounts
Voluntary Life insurance
Voluntary Disability insurance
Accident Insurance
Hospital Indemnity Insurance
Critical Illness Insurance
Identity Theft Insurance
Legal Insurance
Paid time off
Discounts at local fitness clubs
Discounts at AT&T
Additionally, Gastro Health participates in a program called Tickets at Work that provides discounts on concerts, travel, movies, and more.
Interested in learning more? Click here to learn more about the location.
Gastro Health is the one of the largest gastroenterology multi-specialty groups in the United States, with over 130+ locations throughout the country. Our team is composed of the finest gastroenterologists, pediatric gastroenterologists, colorectal surgeons, and allied health professionals. We are always looking for individuals that share our mission to provide outstanding medical care and an exceptional healthcare experience. We offer a comprehensive benefits package to our eligible employees.
Gastro Health is proud to be an Equal Opportunity Employer. We do not discriminate based on race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
We thank you for your interest in joining our growing Gastro Health team!
IP Coder Certified - HIMS IP Coding - Miamisburg - FT/Days
Medical Coder Job In Miamisburg, OH
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Campus Overview
Kettering Health Miamisburg
Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
142 bed facility
Awarded with 100 Top Hospital by IBM Watson Health for the 10
th
time in 2019.
In 2020, KH Miamisburg received an “A” from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
KH Miamisburg received several awards from Healthgrades:
Outstanding Patient Experience Award (2017-2019)
America's 100 Best Hospitals for Prostate Surgery Award (2020)
Joint Replacement Excellence Award (2020)
Responsibilities & Requirements
Responsibilities:
Strong written and verbal communication skills.
Proficient in data entry, personal computers, knowledge of medical terminology, anatomy and physiology and disease processes.
Knowledge and experience with 3M and Epic clinical data system preferred.
Consistently follow coding guidelines and uses coding references to accurately select the appropriate principal diagnosis and procedure as well as secondary diagnoses and procedures.
Evaluates the quality of documentation of all accounts to identify incomplete or inconsistent documentation which affects coding, abstracting and charging and handles appropriately.
Identifies and monitors charging errors to reduce loss of revenue and any other issues regarding correct coding and reimbursement.
Coordinates and performs activities associated with processing and correcting rejected accounts.
Demonstrates knowledge of and adherence to department coding policies and compliance plan.
Maintains certification and demonstrates up-to-date job knowledge.
Preferred Qualifications
Requirements:
Associate or Bachelors' degree in Health Information Management with RHIT or RHIA certification and/or CCS certification.
RHIT/RHIA eligible will also be considered with coding/abstracting experience preferred (must sit for the exam at first available offering after completion of RHIT/RHIT program including passing their certification exam within one year of the first attempt.One to two years coding/abstracting experience in an acute care hospital with RHIT or RHIA certification or three to five years coding/abstracting experience in an acute care hospital with CCS certification.[Ohio, United States] Other
RHIT, RHIA, CCS
Medical Biller & Coder
Medical Coder Job 12 miles from Miamisburg
The job duties of medical billing and coder include:
Enter patient information into computer files, and possibly also in paper records
Organize, manage, and sort paperwork (including patients' charts)
Continue to enter data as patients are subjected to diagnostic tests and receive treatments
Translate the information into alphanumeric medical code
Prepare and mail billing statements
Submit claims to insurance companies and other third-party payers
Process payments from insurance companies
Post transactions and reconcile payments to patient ledgers
Collect and manage patient account payments
Identify past-due bills and recommended collection actions
Ensure that the facility is reimbursed for all services provided
Resolve conflicts regarding payments and reimbursements
Write reports and provide information to government agencies
Respond in writing and on the telephone to patients' questions about billing
Investigate and report instances of insurance fraud
Provide information and prepare documents for legal inquiries and litigation
Ensure the confidentiality of patients' personal information
Perform clerical duties that may include answering the telephone, greeting patients, and sorting mail
Certified Coder
Medical Coder Job 39 miles from Miamisburg
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.
UC Health is committed to providing an inclusive, equitable and diverse place of employment.
Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set.
Coding quality:
* Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG's.
* Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation.
* Maintains a coding accuracy rating of at least 95% on records assigned.
* Queries physicians when necessary to ensure documentation supports the codes assigned.
Coding productivity:
* Performs coding on medical records in an efficient manner meeting productivity standards and assisting the department in meeting and maintaining its goals.
* Completes productivity data correctly and timely.
* Billing edits, coding corrections, DRG changes:
* Reviews, researches, and resolves claim edits for billing purposes.
* Reviews records following feedback from payers, auditors and managers and makes corrections to coding, disposition and/or DRG assignment when indicated.
Accountability:
* Reviews educational materials thoroughly and takes responsibility for applying this information when coding.
* Seeks to clarify information and educational material when necessary.
* Listens actively.
* Maintains information and resources in an organized manner so that information can be referenced easily.
* Reviews emails timely and thoroughly and responds when indicated.
* Manages the remote work setting effectively and comes on site when system, connectivity or other issues arise that would impact work performance.
Minimum Education Required: High School Diploma or GED. Formal education in basic ICD-9CM/CPT coding, Medical Terminology, Anatomy/, pathophysiology and disease processes.
Preferred Education: Associates or Bachelors Degree in a Healthcare related field.
Minimum Experience Required: 1 - 2 Years equivalent experience - At least 1 year of Acute Care Coding.
License and Certifications Required: Certified Coders are required to be certified in one of the following:
* Registered Health Information Technician (RHIT)
* Registered Health Information Administrator (RHIA)
* Certified Coding Specialist (CCS)
Coding Specialist II
Medical Coder Job 34 miles from Miamisburg
Job Overview: This position abstract codes provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Provides coding expertise to department management, coding staff, clinical staff, and billing staff. Meets or exceeds departmental standard related to quality and productivity Job Requirements: Associate's Degree Equivalent experience accepted in lieu of degree CPC, CCS-P, CCM, RHIA, RHIT, CCA Extensive knowledge of ICD-10-CM and CPT coding Methodologies Abstract coding of inpatient and outpatient medical records Extensive knowledge of medical terminology and Anatomy 3-4 years experience in a related field Job Responsibilities: Other job-related information: Current professional coding credential: AAPC (Certified Professional Coder [CPC] Certified Outpatient Coder [COC]) PMI (Certified Medical Coder [CMC]) AHIMA (Certified Coding Specialist-Physician [CCS-P] Certified Coding Specialist [CCS] Registered Health Information Administrator [RHIA] Registered Health Information Technician [RHIT]) Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Consistently Hearing: Conversation - Frequently Hearing: Other Sounds - Frequently Interpersonal Communication - Consistently Kneeling - Rarely Lifting
Lifting 50+ Lbs - Rarely Lifting 11-50 Lbs - Rarely Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Frequently Standing - Occasionally Stooping - Rarely Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Consistently Color Vision - Frequently Visual Acuity: Far - Frequently Visual Acuity: Near - Frequently Walking - Occasionally TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… * Welcome everyone by making eye contact, greeting with a smile, and saying "hello" * Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist * Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… * Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met * Offer patients and guests priority when waiting (lines, elevators) * Work on improving quality, safety, and service Respect: ALWAYS… * Respect cultural and spiritual differences and honor individual preferences. * Respect everyone's opinion and contribution, regardless of title/role. * Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… * Value the time of others by striving to be on time, prepared and actively participating. * Pick up trash, ensuring the physical environment is clean and safe. * Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… * Acknowledge wins and frequently thank team members and others for contributions. * Show courtesy and compassion with customers, team members and the community
Medical Records Coder and Abstractor II - Part-Time
Medical Coder Job 39 miles from Miamisburg
Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, APR-DRG's, SOI, ROM, POA indicators, discharge dispositions and any other clinical data elements required for appropriate reimbursement. Understands and applies reimbursement processes under federal compliance guidelines. Abstracts demographic and clinical data into hospital health information system(s) such as HDM, Epic, or other currently in use. Performs and responds to data quality checks and payer/claims issues. One may specialize in one or more of the standard functions. Specific assignments will vary from day to day based on the needs of the department.
Job Requirements:
Currently enrolled in an approved program for specific field of study in
Within six months of hire, RHIT/RHIA and/or CCS Continuing education pursued in accord with requirements of the accrediting bodies CPC/CCA may be substituted at the hiring manager's discretion
Proficiency in ICD and CPT coding
DRG's
MSDRG's
POA indicators
Post-acute transfer rules
Disposition status
Disease process and treatment
Anatomy and medical terminology
Clinical documentation requirements
AHIMA
Experience in a related field
Job Responsibilities:
Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, POA indicators, discharge dispositions, and other data elements required for appropriate reimbursement, meeting established quality and productivity standards within 3 days of visit/discharge. Meets stated metrics for on-time completion.
Collaborates effectively with associate departments as follows, but not limited to: Performs and responds to data quality checks and payer/claims issues with Billing and Denials teams. Works closely with CDMP toward complete documentation for most descriptive coding and DRG , APR-DRG, SOI, and ROM assignment. Obtains final disposition status from Care Coordination. Supports clinical specialty work teams (i.e. OB and Cardiac Surgery)
Abstracts demographic and clinical data into hospital health data management systems.
Participates in audits, training of new employees, education, project teams, etc. as needed.
Other Job-Related Information:
Working Conditions:
Climbing - Rarely
Concentrating - Consistently
Continuous Learning - Consistently
Hearing: Conversation - Frequently
Hearing: Other Sounds - Frequently
Interpersonal Communication - Consistently
Kneeling - Rarely
Lifting
Lifting 50+ Lbs. - Rarely
Lifting
Pulling - Occasionally
Pushing - Occasionally
Reaching - Occasionally
Reading - Consistently
Sitting - Occasionally
Standing - Frequently
Stooping - Occasionally
Talking - Frequently
Thinking/Reasoning - Consistently
Use of Hands - Frequently
Color Vision - Frequently
Visual Acuity: Far - Frequently
Visual Acuity: Near - Consistently
Walking - Frequently
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:
Serve: ALWAYS…
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS…
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS…
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS…
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS…
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community
Pro Fee Coding Spec - Professional Svcs Coding - Miamisburg - FT/Days
Medical Coder Job In Miamisburg, OH
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Campus Overview
Kettering Health Miamisburg
Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
142 bed facility
Awarded with 100 Top Hospital by IBM Watson Health for the 10
th
time in 2019.
In 2020, KH Miamisburg received an “A” from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
KH Miamisburg received several awards from Healthgrades:
Outstanding Patient Experience Award (2017-2019)
America's 100 Best Hospitals for Prostate Surgery Award (2020)
Joint Replacement Excellence Award (2020)
Responsibilities & Requirements Job Summary
The Pro Fee Coding Specialist reviews, interprets and verifies evaluation and management (E&M) and procedural codes according to the physician's documented office visit notes, orders, hospital notes and other pertinent physician documentation loaded in the medical record. Utilizes coding expertise to accurately code diagnoses based on the physician's documented diagnosis. Identifies and codes global services and/or appropriate concurrent services according to coding guidelines, and applies correct modifiers. Where necessary, corrects codes that have been assigned by physician practices to ensure data and codes are consistent with ICD-10 CM Official Guidelines, CPT, and CMS. Job Requirements Required Licenses[Ohio, United States] Coder, Health Information
One of the following coding certifications: Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT), Certified Coding Specialist Physician (CCS-P) through the American Health Information Management Certification, or, Certified Professional Coder (CPC) through the American Academy of Professional Coders. Required SkillsAdvanced knowledge and understanding of ICD-10 CM Coding Guidelines, CPT, Evaluation and Management Coding and Documentation Guidelines as well as Pro Fee hospital procedure coding and billing. Has excellent customer service and communications skills and able to develop and maintain effective work relationships with team members, staff, leaders, and physicians. Experience with software applications including EPIC, and Microsoft Office (Word, Excel, PowerPoint, and Outlook).
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
Medical Coder Job In Miamisburg, OH
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Responsibilities & Requirements
This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation.
KPN Pro Fee Coding Specialist
Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
* Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
* Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy]
* Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
* Corresponds with providers on pending claims to facilitate resolution
* Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
* Communicate appropriately with providers, leaders, and staff
* Researches and resolves concerns timely
Educational Requirements:
High School Diploma or equivalent
RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification
Prior experience in professional fee coding/billing
Knowledge and Skill:
CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits
Medical Terminology and Anatomy & Physiology
Computer and EPIC Applications
Excellent verbal and written communication skills
Abilities:
Charge Review WQ [Edits]
* Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Claim Edit WQ [Edits]
* Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Follow Up WQ [Denials]
* Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Departmental Responsibilities
* Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
* Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
* Follow procedures pertaining to position
* Researches and resolves concerns timely
MEDICAL RECORDS CODER AND ABSTRACTOR II
Medical Coder Job 39 miles from Miamisburg
Job Overview: Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, APR-DRG's, SOI, ROM, POA indicators, discharge dispositions and any other clinical data elements required for appropriate reimbursement. Understands and applies reimbursement processes under federal compliance guidelines. Abstracts demographic and clinical data into hospital health information system(s) such as HDM, Epic, or other currently in use. Performs and responds to data quality checks and payer/claims issues. One may specialize in one or more of the standard functions. Specific assignments will vary from day to day based on the needs of the department. Job Requirements: Currently enrolled in an approved program for specific field of study in Within six months of hire, RHIT/RHIA and/or CCS Continuing education pursued in accord with requirements of the accrediting bodies CPC/CCA may be substituted at the hiring manager's discretion Proficiency in ICD and CPT coding DRG's MSDRG's POA indicators Post-acute transfer rules Disposition status Disease process and treatment Anatomy and medical terminology Clinical documentation requirements AHIMA Experience in a related field Job Responsibilities: Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, POA indicators, discharge dispositions, and other data elements required for appropriate reimbursement, meeting established quality and productivity standards within 3 days of visit/discharge. Meets stated metrics for on-time completion. Collaborates effectively with associate departments as follows, but not limited to: Performs and responds to data quality checks and payer/claims issues with Billing and Denials teams. Works closely with CDMP toward complete documentation for most descriptive coding and DRG , APR-DRG, SOI, and ROM assignment. Obtains final disposition status from Care Coordination. Supports clinical specialty work teams (i.e. OB and Cardiac Surgery) Abstracts demographic and clinical data into hospital health data management systems. Participates in audits, training of new employees, education, project teams, etc. as needed. Other Job-Related Information: Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Consistently Hearing: Conversation - Frequently Hearing: Other Sounds - Frequently Interpersonal Communication - Consistently Kneeling - Rarely Lifting
Lifting 50+ Lbs. - Rarely Lifting
Pulling - Occasionally Pushing - Occasionally Reaching - Occasionally Reading - Consistently Sitting - Occasionally Standing - Frequently Stooping - Occasionally Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Frequently Color Vision - Frequently Visual Acuity: Far - Frequently Visual Acuity: Near - Consistently Walking - Frequently TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… * Welcome everyone by making eye contact, greeting with a smile, and saying "hello" * Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist * Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… * Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met * Offer patients and guests priority when waiting (lines, elevators) * Work on improving quality, safety, and service Respect: ALWAYS… * Respect cultural and spiritual differences and honor individual preferences. * Respect everyone's opinion and contribution, regardless of title/role. * Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… * Value the time of others by striving to be on time, prepared and actively participating. * Pick up trash, ensuring the physical environment is clean and safe. * Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… * Acknowledge wins and frequently thank team members and others for contributions. * Show courtesy and compassion with customers, team members and the community
Medical Records Coder And Abstractor II
Medical Coder Job 39 miles from Miamisburg
Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, APR-DRG's, SOI, ROM, POA indicators, discharge dispositions and any other clinical data elements required for appropriate reimbursement. Understands and applies reimbursement processes under federal compliance guidelines. Abstracts demographic and clinical data into hospital health information system(s) such as HDM, Epic, or other currently in use. Performs and responds to data quality checks and payer/claims issues. One may specialize in one or more of the standard functions. Specific assignments will vary from day to day based on the needs of the department.
Job Requirements:
Currently enrolled in an approved program for specific field of study in
Within six months of hire, RHIT/RHIA and/or CCS Continuing education pursued in accord with requirements of the accrediting bodies CPC/CCA may be substituted at the hiring manager's discretion
Proficiency in ICD and CPT coding
DRG's
MSDRG's
POA indicators
Post-acute transfer rules
Disposition status
Disease process and treatment
Anatomy and medical terminology
Clinical documentation requirements
AHIMA
Experience in a related field
Job Responsibilities:
Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, POA indicators, discharge dispositions, and other data elements required for appropriate reimbursement, meeting established quality and productivity standards within 3 days of visit/discharge. Meets stated metrics for on-time completion.
Collaborates effectively with associate departments as follows, but not limited to: Performs and responds to data quality checks and payer/claims issues with Billing and Denials teams. Works closely with CDMP toward complete documentation for most descriptive coding and DRG , APR-DRG, SOI, and ROM assignment. Obtains final disposition status from Care Coordination. Supports clinical specialty work teams (i.e. OB and Cardiac Surgery)
Abstracts demographic and clinical data into hospital health data management systems.
Participates in audits, training of new employees, education, project teams, etc. as needed.
Other Job-Related Information:
Working Conditions:
Climbing - Rarely
Concentrating - Consistently
Continuous Learning - Consistently
Hearing: Conversation - Frequently
Hearing: Other Sounds - Frequently
Interpersonal Communication - Consistently
Kneeling - Rarely
Lifting
Lifting 50+ Lbs. - Rarely
Lifting
Pulling - Occasionally
Pushing - Occasionally
Reaching - Occasionally
Reading - Consistently
Sitting - Occasionally
Standing - Frequently
Stooping - Occasionally
Talking - Frequently
Thinking/Reasoning - Consistently
Use of Hands - Frequently
Color Vision - Frequently
Visual Acuity: Far - Frequently
Visual Acuity: Near - Consistently
Walking - Frequently
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:
Serve: ALWAYS…
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS…
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS…
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS…
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS…
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community
Pro Fee Coding Spec - Miamisburg - Professional Svc Coding - FT Days
Medical Coder Job In Miamisburg, OH
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Responsibilities & Requirements
This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation.
KPN Pro Fee Coding Specialist
Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy]
Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
Corresponds with providers on pending claims to facilitate resolution
Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
Communicate appropriately with providers, leaders, and staff
Researches and resolves concerns timely
Educational Requirements:
High School Diploma or equivalent
RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification
Prior experience in professional fee coding/billing
Knowledge and Skill:
CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits
Medical Terminology and Anatomy & Physiology
Computer and EPIC Applications
Excellent verbal and written communication skills
Abilities:
Charge Review WQ [Edits]
Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Claim Edit WQ [Edits]
Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Follow Up WQ [Denials]
Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Departmental Responsibilities
Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
Follow procedures pertaining to position
Researches and resolves concerns timely
Pro Fee Coding Spec - Professional Svcs Coding - Miamisburg - FT/Days
Medical Coder Job In Miamisburg, OH
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
Campus Overview
Kettering Health Miamisburg
* Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
* Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
* The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
* Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
* 142 bed facility
* Awarded with 100 Top Hospital by IBM Watson Health for the 10th time in 2019.
* In 2020, KH Miamisburg received an "A" from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
* Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
* KH Miamisburg received several awards from Healthgrades:
* Outstanding Patient Experience Award (2017-2019)
* America's 100 Best Hospitals for Prostate Surgery Award (2020)
* Joint Replacement Excellence Award (2020)
Responsibilities & Requirements
Job Summary The Pro Fee Coding Specialist reviews, interprets and verifies evaluation and management (E&M) and procedural codes according to the physician's documented office visit notes, orders, hospital notes and other pertinent physician documentation loaded in the medical record. Utilizes coding expertise to accurately code diagnoses based on the physician's documented diagnosis. Identifies and codes global services and/or appropriate concurrent services according to coding guidelines, and applies correct modifiers. Where necessary, corrects codes that have been assigned by physician practices to ensure data and codes are consistent with ICD-10 CM Official Guidelines, CPT, and CMS. Job Requirements Required Licenses[Ohio, United States] Coder, Health InformationOne of the following coding certifications: Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT), Certified Coding Specialist Physician (CCS-P) through the American Health Information Management Certification, or, Certified Professional Coder (CPC) through the American Academy of Professional Coders. Required SkillsAdvanced knowledge and understanding of ICD-10 CM Coding Guidelines, CPT, Evaluation and Management Coding and Documentation Guidelines as well as Pro Fee hospital procedure coding and billing. Has excellent customer service and communications skills and able to develop and maintain effective work relationships with team members, staff, leaders, and physicians. Experience with software applications including EPIC, and Microsoft Office (Word, Excel, PowerPoint, and Outlook).