Coding Edits Specialist
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Job Description
Remote coding specialist assigning accurate ICD-10-CM, CPT, and HCPCS codes for Lifepoint Health’s community-based hospitals. Reviewing documentation, resolving coding issues, and supporting compliant billing.
Responsibilities:
- Assign diagnosis and procedure codes for emergency department, same-day surgery, outpatient clinic, observation, inpatient OB newborn, and specialty clinic encounters
- Analyze questionable documentation and resolve identified issues to ensure coding accuracy
- Assign ICD-10-CM, CPT, and HCPCS codes according to CMS hospital billing requirements
- Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards
- Verify, edit, and/or enter charges based on documentation or payer/billing information
- Follow coding workflows and address compliance reviews
- Submit physician queries when documentation clarification is needed
- Collaborate with physicians, nurses, medical staff, and hospital employees
- Assist with training and reviewing other coders’ work
- Make recommendations to the supervisor and implement and monitor results
- Adjust work schedule to meet department needs
- Attend coding education webinars, conference calls, seminars, and discussions
- Complete compliance courses and maintain applicable coding credentials
- Perform other related duties as assigned
Requirements:
- Associate degree in health-related field preferred
- One year of outpatient coding experience in an acute care hospital preferred
- Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) preferred
- Proficiency with ICD-10-CM, CPT, and HCPCS
- Familiarity with Ambulatory Payment Categories (APCs), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) guidelines, Local and National Coverage Decisions, and medical necessity/compliance guidelines
- Knowledge of applicable rules, regulations, policies, laws, and guidelines affecting coding
- Ability to work effectively remotely using independent discretion and decision-making
- Must be authorized to work in the United States without employer sponsorship
- Ability to attend required educational webinars, conference calls, and coding seminars
- Ability to maintain coding education hours and renew annual coding credentials as applicable
- Ability to complete assigned compliance courses within the designated period
- Ability to conform to AHIMA’s Code of Ethics and Standards of Ethical Coding
- Ability to maintain confidentiality and patient/employee privacy
Benefits:
- Multiple levels of medical, dental and vision coverage for full-time and part-time employees
- Life, accident, critical illness and hospital indemnity insurance
- Short- and long-term disability insurance
- Paid family leave
- Paid time off
- Higher education and certification tuition assistance
- Loan assistance
- 401(k) retirement package and company match
- Mental, physical and financial wellness programs
- Free gym memberships
- Virtual care appointments
- Mental health services
- Discount programs
- Ongoing learning and career advancement opportunities
- Flexible schedule: make your own schedule
- Remote work arrangement
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