Medical Coder (Fully Remote)

Robert Half is currently partnering with a health care provider in search of several full time, fully remote Medical Coding Specialist positions. This position is responsible for reviewing medical record documentation and accurately assign ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Candidates with prior experience coding for a variety of specialties, including cardiology, thoracic surgery, neurology, OBGYN, vascular, anesthesia and general surgery are needed for this growing client.

Job Responsibilities

• Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types (Ancillary, ED Charge/Code, Same Day Surgery, and Observation. All assigned codes must support the reason for the visit and the medical necessity that has been documented by the provider to support the care provided.
• Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines.
• Correctly abstract required data per facility specifications.
• Responsible for working with other revenue cycle teams to determine and fix any coding issues that result in a claim being denied.
• Responsible for maintaining established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards.
• Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS,) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through.
• Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC,) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy

Ideal Experience

• 1+ years of previous medical coding experience
• PC and Computer application knowledge and experience. Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).
• Excellent organization skills, communication, time management, trouble shooting and problem solving.
• Ability to multi-task and prioritize needs to meet short- and long-term timelines.
• Experience with EPIC and previous use of coding software tools.