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Professional Services Coder 3 - Multispecialty Edits/Denials

Company: R1 RCM
Location: Chicago
Posted on: September 25, 2022

Job Description:

Shift Days: Monday- Friday, Shift Hours: VariesR1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals, and physician practices. Headquartered in Chicago, R1 is a publicly traded organization with employees throughout the US and international locations.Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients, and each other. With our proven and scalable operating model, we complement a healthcare organizations infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.The Professional Services Coder 3 - Multispecialty Edits/Denials will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance). with emphasis on Edits/DenialsUnder the direction of the Coding Leadership Team, the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.Responsibilities:

  • Assigns codes for diagnoses, treatments, and procedures according to the
  • appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
  • Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.
  • Able to accurately abstract information from the medial records into the abstract system, according to established guidelines.
  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines
  • Enters and validates codes, charges and other edits flagged in Athena or EPIC for review.
  • Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units)
  • Uses CCI edit software to check bundling issues, modifier appropriateness, and LCDs/NCDs for medical necessity.
  • Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns.
  • Meet and/or exceeds the established coding productivity standards
  • Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standardsRequired Qualifications:
    • High School Diploma or GED required
    • CCS-P, CPC
    • Minimum of 3 years professional coding experience in Edits/Denials; Multispecialty Coding
    • Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (ie: Documentation Guidelines 95 & 97)
    • Extensive knowledge of government, and commercial payer guidelines.
    • Must be able to use standard office equipment and information systems.
    • Must be able to travel to other sites for meetings and/or coder back-up.
    • Ability to interact with other employees through effective communication.
    • Ability to prioritize and shift workloads to ensure departmental goals align with revenue cycle goalsWorking in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests.Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including: Comprehensive Medical, Dental, Vision & RX Coverage Paid Time Off, Volunteer Time & Holidays 401K with Company Match Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability Tuition Reimbursement Parental LeaveR1 RCM Inc. (the Company) is dedicated to the fundamentals of equal employment opportunity. The Companys employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any persons age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company provides a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.To learn more, visit: R1RCM.comWorking in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including:
      • Comprehensive Medical, Dental, Vision & RX Coverage
      • Paid Time Off, Volunteer Time & Holidays
      • 401K with Company Match
      • Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability
      • Tuition Reimbursement
      • Parental LeaveR1 RCM Inc. (the Company) is dedicated to the fundamentals of equal employment opportunity. The Companys employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any persons age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.To learn more, visit: R1RCM.comVisit us on Facebook (https://www.facebook.com/R1RCM)

Keywords: R1 RCM, Chicago , Professional Services Coder 3 - Multispecialty Edits/Denials, Other , Chicago, Illinois

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