We're looking for a Coding Specialist II- Risk Adjustment Coder to join our team! In this role, you'll be responsible for reviewing inpatient and outpatient medical records for documentation, abstracting and analyzing. You'll assign all codes to the highest level of specificity following the current guidelines for ICD-10-CM, CPT, and HCPCS and understand and properly apply modifiers, CCI edits, medical policy rules (e.g., LCD/NCD), etc., in compliance with payor regulations. Location:This position is open to remote/work from home with strong preference for candidates residing within the UPH geographies of Iowa, Illinois, & Wisconsin.
Why UnityPoint Health? Commitment to our Team – We've been named a Top 150 Place to Work in Healthcare 2022 by Becker's Healthcare for our commitment to our team members.
Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve. Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you're in. Diversity, Equity and Inclusion Commitment – We're committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation. Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience. Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve. Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. Coding and Department Support Assigns procedural codes according to coding conventions defined by the American Medical Association's CPT manual, CMS, including the Correct Coding Initiative, Medicaid and other third- party payor policies as applicable. Assigns diagnosis codes according to the ICD-9 and/or ICD-10 Official Guidelines for Coding an Reporting. Working knowledge of modifiers, CCI edits, HCPCs, LCD/NCDs and other applicable tools to insure compliance with payer regulations. Research and resolve coding related issues accordingly per established EPIC Charge Review Work Queue functionality. Collaborate with Clinical Auditors to identify opportunities for improvement and provide guidance/counsel to providers. Monitor environmental conditions in order to secure protected health information. Consistently research and resolve coding related denials per payer regulations. Charge entry of CPT and ICD-9/ICD-10 codes Collection and/or analysis of coding-related data for training purposes or presentation as needed. Education: Highschool Diploma/GED Experience: Three (3) years professional coding experience. Preferred: Minimum of 3+ years of diagnosis coding experience Risk adjustment coding experience Knowledge of CPT and E&M Strong ICD-10 knowledge License(s)/Certification(s): Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC) certification status required. Preferred: Certified Risk Adjustment Coder (CRC). Must receive certification within one year of hire date. Knowledge/Skills/Abilities: Ability to handle complex procedural coding (i.e., invasive & image guided procedures, complex surgical cases) in both inpatient and outpatient settings. Expertise in Evaluation and Management coding in both inpatient and outpatient settings. Experience training/mentoring new coders or staff. Knowledge of ICD-9/ICD-10 diagnosis, Current Procedural Terminology (CPT) and HCPCS codes. Advanced knowledge and/or training related to Risk Adjustment coding and Hierarchical Condition Categories. Advanced knowledge of medical terminology, anatomy, and physiology. Extensive knowledge of regional business lines and related workflows. Ability to understand government and non-governmental policies and procedures and apply guidelines. Knowledge of medical billing and third-party reimbursement policies. Strong interpersonal and communication skills. Ability to work as a team member. Strong computer skills. Strong verbal and written communication skills.
