The Registered Nurse Certified Medical Coder objectively and accurately examines medical records and documentation on assigned charts and assigns appropriate and accurate billing codes.
Reasonable Accommodations Statement
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Essential Functions Statement(s)
- Conduct medical chart reviews. Clinically validate the medical appropriateness and coding accuracy of services rendered in an inpatient setting.
- Exhibits a working knowledge of third party payer rules and regulations and billing practices, policy, and procedure.
- Possesses a fundamental knowledge of ICD 10 and are encouraged to seek HCS-D certification.
- Utilizes physician documentation including clinic notes and hospital records to assist in determining the most accurate medical diagnosis codes.
- Create narrative rationale to correspond audit determinations.
- Serve as a clinical resource; provide clinical expertise, and clinical guidance to the team.
- Works collaboratively with the audit team to identify vulnerabilities and/or cases subject to potential Fraud Waste and Abuse (FWA).
- Monitors, tracks and reports on all work conducted.
- Consults with our clients, physicians, other clinical resources and contractors as necessary.
- Participates in process improvement activities and encourages ownership of and group participation in improvement initiatives.
- As needed, assist with quality assurance functions, development of medical review and coding guidelines and training.
- Maintain a current knowledge of Medicare and Commercial regulations, policies and procedures,
- Identify and recommends opportunities for cost savings and improving outcomes.
- Attend conference calls and meetings as requested.
- Maintain coding certification to ensure eligibility to perform audits on behalf of Performant.
- Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
- Active Listening - Ability to actively attend to, convey, and understand the comments and questions of others.
- Applied Learning - Ability to participate in needed learning activities in a way that makes the most of the learning experience.
- Assertiveness - Ability to act in a self-confident manner to facilitate completion of a work assignment or to defend a position or idea.
- Empathetic - Ability to appreciate and be sensitive to the feelings of others.
- Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.
- Research Skills - Ability to design and conduct a systematic, objective, and critical investigation.
- Tactful - Ability to show consideration for and maintain good relations with others.
- Accountability - Ability to accept responsibility and account for his/her actions.
- Organized - Possessing the trait of being organized or following a systematic method of performing a task.
- Analytical Skills - Ability to use thinking and reasoning to solve a problem.
- Communication, Oral - Ability to communicate effectively with others using the spoken word.
SKILLS & ABILITIES
- Bachelor's Degree (four year college or university) preferred
- Board Certified Home Health Coder preferred
Experience: One to two years related experience
- Kinnser Software
- Google Documents
Job Type: Full-time
Pay: $45,000.00 - $65,000.00 per year
- 401(k) matching
- Dental insurance
- Disability insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
COVID-19 vaccine not required at this time.
- ICD-10: 2 years (Required)
- Board Certified Home Health Coder (Preferred)
- RN (Preferred)
Work Location: Remote