Employment Type:
Full time

Shift:
Day Shift

Description:
Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/ clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties. Remote

Position Summary:

Responsible for charge capture process for professional charges within the SMHC system, including but not limited to: verifying and/or analyzing medical record documentation to determine the principle and all secondary diagnoses and procedures; and assigning diagnostic and procedural codes using coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and SMHC. Assists in the orientation and training of new employees within the coding and charge capture area.

What the Professional Surgical Coder will need:

• Minimum - Associates Degree in allied health related field, including classes in medical terminology, anatomy and physiology; or two years of increasingly responsible medical records experience with exposure to medical terminology, anatomy, physiology, and coding; or an equivalent combination of education and experience.
• Minimum – Certified Coding Specialist credentialing
• One – three (1-3) years of professional coding experience, with multiple surgical specialties preferred
• Preferred - prior experience in coding for neurosurgery, thoracic surgery, and / or gynecologic oncology procedures
• Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations.
• Solid understanding of ICD-9 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans.
• Ability to maintain accurate records and to prioritize and organize work effectively.
• Ability to exercise independent judgment as appropriate within standard practices and procedures.

What the Professional Surgical Coder will do:

• Performs coding and charge entry of surgical services dropped in Epic with a generic placeholder or PBSUR.
• Detailed in code selections.  Maintains accuracy of 95% or greater.
• Performs accurate resolve of assigned hospital-based and surgical charge review errors and claim edits in Epic, keeping WQ aging < 2 days.
• Reviews documentation in Epic or other sources to appropriately determine ICD-10, CPT, HCPCS, and modifier assignment.
• Researches all information needed to complete coding process.
• Follows daily, weekly & monthly productivity requirements.
• Resolves coding discrepancies related to coding and revenue capture.
• Participates in the liaison process between the Centralized Coding, Providers, Managers, and Leadership.
• Obtains and maintains relevant education to perform essential functions; keeps coding credentials (CPT, CCS) current at all times.
• Serves as a resource for providers, managers, peers.
• Performs other related duties as assigned.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.