Pro-Fee Coder – General Surgical

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

The Coding Specialist II will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of professional billing and reimbursement.  The Coder II will use standard ICD-CM and CPT professional coding guidelines, CMS, third party payer and/or client specific coding guidelines.  The Coder II may interact with client staff and providers.

JOB ACCOUNTABILITIES:

•  Review provider charges and/or select and sequence ICD-10-CM, CPT, HCPCS and modifiers for ambulatory visits and procedures, Emergency Department visits and procedures, observation, outpatient and inpatient hospital professional services, bedside procedures, ancillary procedures and/or simple surgical coding (including but not limited to E&M visits, diagnostic tests, point of care tests, in-office procedures, injections/ infusions, non-operating room or simple surgical procedures).

• Review clinical documentation to ensure it substantiates professional charges and create professional, effective and compliant queries directed to providers and/or other clinical staff when existing documentation is unclear or ambiguous.

• Using correct coding guidelines and/or client specific guidelines, review and edit charges appropriately to resolve claim edits and coding related denials.

• Researches specific questions/issues or conducts special projects as assigned.

• Participates in training and/or auditing other coding colleagues and acts as a mentor when assigned.

• Serves as a subject matter expert and represents the client in meetings and/or on committees as requested.

• Manual data entry of charges into EMR as needed.

• Complete assigned work functions utilizing appropriate resources.

• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.

• Maintain strict patient and provider confidentiality in compliance with HIPPA

• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.

• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.

• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
• Support Savista’s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient and/or client information.

• Performs other related duties as assigned or requested.

QUALIFICATIONS:

Candidates must successfully pass pre-employment skills assessment. Required:

• High School diploma or GED.
  • An active AAPC (American Academy of Professional Coders) credential (CPC) or an active AHIMA (American Health Information Association) credential (CCA, CCS, CCS-P).
  • Meet two of the following criteria:
    • Have a minimum of five (5) years coding experience as a certified coder (in any setting) and experience coding for five (5) different inpatient specialties
    • Have a minimum of two (2) years’ experience in ancillary procedural or simple surgical coding
    • Have a minimum of two (2) years’ experience in coding complex inpatient hospital professional services (i.e. Critical Care, Surgical, Trauma services)
  • Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets.
  • Ability to consistently code at 95% threshold for both accuracy and quality while maintaining client-specific and/or Savista production and/or quality standards
  • Proficient computer knowledge including MS Office (Outlook, Word, Excel)
  • Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers

• Demonstrates ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Excel and use company email and calendar tools.
• Demonstrated success working both individually and in a team environment.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures and/or governmental regulations.

Preferred:

Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience.

• Recent and relevant experience in an active production coding environment strongly preferred.
• Academic medical center knowledge preferred.
• Trauma center knowledge preferred.

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 – $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.