Kootenai Professional Services Coder II

Unclassified - Coeur d'Alene, ID

Part-time - Entry Level

Hybrid - Coeur d'Alene, ID

About the position

The Kootenai Professional Services Coder II is responsible for the timely and accurate assignment of ICD-0 and CPT, HCPC codes to reflect services documented in the medical record in accordance with regulatory guidelines. This position requires a demonstration of coding competencies with a focus on the quality of coding and daily output of volume that aligns with department productivity standards. The coder will review medical records to assign ICD-0, CPT, and HCPC codes and modifiers, ensuring compliance with hospital guidelines and the current version of ICD Official Guidelines for Coding and Reporting, as well as UHDDS. In this role, the coder will accurately assign and sequence diagnostic and procedure codes, ensuring the correct assignment of modifiers. They will seek clarification from providers or designated resources to ensure accurate and complete documentation for coding as appropriate. Education will be provided to all assigned providers, and the coder will work collaboratively with the Business Office billing team to address specific payer denial reasons and assist in appeal letters as necessary. The coder is also responsible for maintaining a working knowledge of reimbursement as it relates to coding, particularly the government prospective payment systems. They will identify compliance concerns and education opportunities to the Coding Manager and communicate regulatory documentation requirements and education to providers and staff as necessary. Collaboration with Clinic Managers and the Coding Manager will be essential to define process improvements. The position may require working directly with providers in the clinic as assigned. All functions must be performed according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. The coder is expected to achieve and maintain a high level of accuracy and productivity in coded claims and perform other related duties as assigned. Regular and predictable attendance is an essential job function, and the coder will enhance and maintain their coding knowledge and skills by attending meetings and traveling to other sites as necessary.

Responsibilities

• Reviews the medical record for the assignment of ICD-0, CPT, HCPC codes and modifiers in compliance with hospital guidelines, the current version of ICD Official Guidelines for Coding and Reporting, and UHDDS.
• Assigns and sequences diagnostic and procedure codes accurately.
• Ensures accurate assignment of modifiers.
• Seeks clarification from providers or designated resources to ensure accurate and complete documentation for coding as appropriate.
• Provides education to all assigned providers.
• Works in collaboration with the Business Office billing team for specific payer denial reasons.
• Assists in appeal letters as necessary.
• Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems.
• Identifies compliance concerns and education opportunities to the Coding Manager.
• Communicates regulatory documentation requirements and education to providers and staff as necessary.
• Works collaboratively with Clinic Managers and Coding Manager to define process improvements.
• May be required to work in the clinic; as assigned to work directly with provider(s).
• Performs all functions according to established policies, procedures, regulatory and accreditation requirements as well as applicable professional standards.
• Achieves and maintains a high level of accuracy and productivity in coded claims.
• Performs other related duties as assigned.
• Enhances and maintains coding knowledge and skills.
• Attends meetings and travels to other sites as necessary.

Requirements

• High school diploma or equivalent preferred.
• Coding certification required; AAPC or AHIMA.
• Knowledge of anatomy and physiology, medical terminology, and pharmacology preferred.
• Minimum of 3 years professional services and billing experience.
• Demonstrated knowledge of ICD-0/CPT/HCPC coding principles, coding software and the AHIMA coding competencies.
• Ability to work effectively in multiple EMRs including but not limited to Epic, and to code for multiple specialties within priority assignment.
• Excellent verbal and written communication skills, and ability to maintain positive working relationships with all levels of clinic staff, including while conducting provider education.
• Knowledge of payer specific billing regulations required.
• Knowledge of 3M Software preferred.

Benefits

• 100% employer-paid health insurance premiums for full-time employees.
• Tuition assistance program available after 90 days.
• Kootenai Health will match contributions in a defined contribution 457 retirement plan based on years of service ranging from 3-6 percent.
• Competitive salaries with night, weekend and PRN shift differentials.
• An award-winning and incentive-driven wellness program.
• Employees receive discounts at The Wellness Bar, PEAK Fitness, various cell phone carriers, and more.
• Robust and interactive employee bonus program.