Certified Surgery/Observation Coder

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Evaluate provider documentation and modify or allocate ICD-10-CM and CPT/HCPCS codes

• Investigate and take necessary actions on coding and claim discrepancies

• Execute intricate outpatient hospital-based coding for Observation, Emergency Department, Wound, and Ambulatory Surgery services

• Conduct provider-based complex procedural coding for surgeries, procedures, and wound care services

• Assess and either accept or adjust provider-selected codes in line with documentation and coding regulations

• Analyze provider documentation and assign suitable codes for non-provider-selected coding

• Address coding edits to ensure encounters are processed for claims

• Communicate with providers or send queries when further information is required

• Recognize and report documentation, coding, or system-related issues that impact quality, compliance, or efficiency

• Complete assigned work queue tasks as directed by the Coding Lead/Supervisor/Manager

• Engage in performance improvement initiatives and participate in departmental meetings

• Uphold coding quality, productivity, and necessary CEU standards

⛳️ Requirements

• High School Diploma is mandatory

• RHIA, RHIT, or CCS (hospital) certification is required

• RHIA, RHIT, CCS, CCS-P, CCA, or CPC (provider-based) certification is necessary

• For provider-based coding: 3 years of procedural coding experience is required for CCS-P, CCA, or CPC holders

• Familiarity with official coding guidelines is essential

• Proficiency in using encoding software and reference materials is needed

• Capability to uphold coding quality and productivity standards

• Must maintain required CEUs

• Intermittent hand manipulation is required

• Occasional lifting and carrying of up to 20 pounds

🏝️ Benefits

• Benefits information is available through the employer's Benefits Guide/Plan Information link