Outpatient Professional Fee Coder, Family Practice, Assisted Living, Nursing Home Visits

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 according to established coding guidelines.

• Investigate and take necessary actions on coding and claim modifications.

• Code provider-based E&M level visits or outpatient hospital-based ancillary appointments.

• Adhere to coding policies, procedures, and standard operational protocols.

• Utilize encoding software and reference materials to assign the correct codes.

• Analyze and either approve or modify provider-driven code selections based on documentation and coding standards.

• Allocate appropriate codes for non-provider-driven coding in accordance with provider documentation and coding guidelines.

• Review coding discrepancies and accurately resolve them to ensure encounters can proceed to claims.

• Provide clear communications to providers via in-basket messages or inquiries when additional information is required.

• Report documentation, coding, or system issues that impact quality, compliance, or productivity to the Coding Lead/Supervisor/Manager.

• Execute work queue responsibilities assigned by the Coding Lead/Supervisor/Manager.

• Uphold coding quality and productivity benchmarks.

• Engage in performance improvement initiatives, department meetings, and other mandatory meetings.

• Maintain required Continuing Education Units (CEUs).

⛳️ Requirements

• A High School Diploma is mandatory.

• Credentials such as RHIA, RHIT, CCS, CCS-P, CCA, or CPC are essential.

• For CCS-P, CCA, or CPC: A minimum of 1 year (2,000 continuous working hours) of experience is required.

• Capability to review provider documentation and assign or modify ICD-10-CM, CPT, and HCPCS codes in line with official coding guidelines.

• Proficiency in researching and resolving coding and claim edits.

• Competence in effectively using encoding software and reference materials.

• Ability to uphold coding quality and productivity standards.

• Maintenance of required CEUs is necessary.

• An Associate or Bachelor’s Degree in Health Information or a related healthcare field is preferred.

🏝️ Benefits

• Abundant opportunities for professional development and growth.

• A commitment to excellence in patient care.

• Tobacco-free environments at SIH and SIH Medical Group campuses.

• Accessible benefits plan information through the SIH Benefits Guide.