Children’s Wisconsin, we believe kids deserve the best.
Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.
We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.
The Professional Coding Specialist III will work in collaboration with Ancillary or specialty departments/locations/providers to code, review and release charges in a timely manner and to ensure correct coding, billing compliance and complete charge capture.
Minimum Requirements and Responsibilities
Collaborates with providers and other departmental staff/leaders on coding or charge capture related questions/topics.
High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED).
Requires 3 years of experience in coding and /or health care experience.
Exhibits guiding behaviors that reflect Children’s values and support our mission and vision.
Knowledge of ICD10, CPT and HCPCS coding guidelines.
Working knowledge of CCI edits, healthcare insurance guidelines and other regulatory guidance.
Prior use of an Electronic Health Record. Excellent communication (oral and written) skills.
Ability to work independently, exercise independent judgment and solve problems effectively. Specialty Coding knowledge.
Normal office environment where there is no reasonable potential for exposure to blood or other high risk body fluids.
Remote work (home).
Epic experience preferred.
This is a 100% remote position.
Children’s Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.
Certifications/Licenses:
About Us
Dedicated solely to the health and well-being of children
We are the region’s only independent healthcare system dedicated solely to the health and well-being of children. In Milwaukee and throughout the state, we provide kids and their families a wide range of care and support – everything from routine care for ear aches or sore throats to life saving advances and treatment options. Our academic partner, The Medical College of Wisconsin, brings many of the nation’s most well-respected doctors to our team. Together we work to ensure that every child and family we serve receives nothing but the best. Learn more about our affiliation with the Medical College of Wisconsin and the power of academic medicine.
Primary Location Salary Range:$24.32 – $36.48 / hour, based on education & experience
In accordance with State Pay Transparency Rules.
A rewarding career that fits your life. As an employer of the future, we are proud to offer our team members many career and lifestyle choices including remote work options. If you’re looking to leverage your abilities – you belong at Banner Health.
Are you a superstar strong OBGYN Physician Complex Coder | Medical Coder looking for the opportunity to code a wide variety of accounts? The ideal candidate would have 3 years+ of coding experience ideally in OBGYN. There are also opportunities for overtime with special projects from time to time. This requires being fully CPC (AAPC) or CCS or CCA (AHIMA)certified. Come join a strong team of 10 Coder with an Associate Director and Associate Manager.
If you are interested in a career with OBGYN, then Banner is the place you want to be. With our complex OBGYN Coder position, you will have the opportunity to code in our academic or non-academic team. Here at Banner you will be exposed to not only OBGYN services within our OBGYN teams we have subspecialties that belong to our clinics, such as Maternal Fetal Medicine where you would be coding for high risk pregnancies and deliveries, ultrasounds and some procedures, you will see specialized surgical cases related to pelvic organ prolapse and urinary retention, In Gynecology Oncology with this specialty you would be coding more complex Hysterectomies, pelvic exenterating, and robotic cases related to female cancers. With this group of subspecialties in OBGYN you have more opportunities to learn other services with our specialties that not all OBGYN offices perform is on this team. Production expectations depend on placement anywhere from 6 to 12 charts an hour. This is a great opportunity to build your OBGYN coding resume.
Banner Health provides your equipment when hired. You will be fully supported in training with continued support throughout your career here!
This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MD, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY.
The hours are flexible as we have remote Coders across the Nation. Generally, any 8-hour period between 7am – 7pm can work, with production being the greatest emphasis. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you’ll find many options for contributing to our award-winning patient care.
POSITION SUMMARY
This position evaluates medical records, provides clinical and surgical abstraction for full range of complex and/or multispecialty surgical, procedural and E&M professional services in accordance with nationally recognized coding guidelines. Utilize coding knowledge and expertise to support department projects, validation edits and/or revisions.
CORE FUNCTIONS
1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor or individual department for clarification/additional information for accurate code assignment.
3. Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
4. As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.
5. Able to identify validation edits and revision issues to ensure compliant coding.
6. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.
7. Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT codes according to national guidelines. May seek guidance for correct interpretation of coding guidelines and LCDs (Local Coverage Determinations).
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.
Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty.
Requires three or more years of complex professional coding experience within specialty.
Must demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders.
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.
PREFERRED QUALIFICATIONS
Specialty Certification. Radiology Certified Coder (RCC) if employed in the Imaging space. Experience in a large, multi-system physician practice preferred.
Additional related education and/or experience preferred.
UPMC Children’s Hospital of Pittsburgh is currently seeking a Full-Time Trauma Registrar. This is a remote (work from home) position with flexible working hours. If you are a self-motivated, detail oriented, independent worker, we invite you to apply today!
The Trauma Registrar maintains the efficient operation of the Trauma Patient Registry. The Trauma Registrar ensures consistency and quality in the data collection system, identification of trauma patient, admissions, abstracting, coding and entering information into the trauma database. Retrieves data for quality assurance purposes. Complies with Pennsylvania Trauma Systems Foundation requests for data. Works closely with the Trauma QA/Registry Coordinator and Trauma Program Manager. Also interacts with Medical Records, Information Services personnel, and patient unit staff.
Responsibilities:
Document data and time of attendance at continuing education programs.
Demonstrate an awareness of the hospital’s commitment to provide excellence in trauma patient care by supporting the Trauma Program’s service management objectives.
Perform related responsibilities as requested by the Trauma Program Manager.
Follow protocol for removing or adding patients to the database.
Identify appropriately trauma patients by monitoring on a daily basis the Emergency Department and Admitting Department identification systems.
Perform additional trauma patient medical record abstracting or audit activities for quality assurance, research, education, or for the purpose of identifying and addressing documentation deficiencies.
Engage in follow-up activity as appropriate
Accurately maintain the computerized registry system, which includes keying data, making additions, and making corrections as necessary.
Contact appropriately the Trauma QA/Registry Coordinator for problem solving and clarification of clinical information.
Maintain accurately the statistical database, generate routine monthly reports, and respond to special requests for statistical information.
Work with the Trauma Nurse Specialist and Trauma QA/Registry Coordinator to collect, organize, and disseminate results.
Maintain confidentiality of patient information and follow hospital policies relating to security of patient information.
Ensure that all PTOS information is accurate, complete, and submitted within the time frames established by PTOS protocol.
Maintain communications with the state Trauma Registrar and/or PTOS analysts for purposes of clarifying information or respond to requests for clarification of information.
Maintain and expand current knowledge base through attendance at appropriate in-services or seminars and by studying reference material.
Abstract from the trauma patient medical record relevant information required for the hospital registry and the Pennsylvania Trauma Outcome Study, including selection and coding of diagnoses and procedures using ICD9-CM, and calculation of trauma and Injury Severity Scores accurately and efficiently.
Retrieve information from the database upon request of Trauma Services or other appropriate personnel.
Determine the data elements and design the output for the request.
Attend and participate in Trauma QI activities such as MAC meetings.
Conduct concurrent review of trauma patient records within 48 hours of admission and enter select information into the database to provide current information for quality assurance, outreach, education, and public relations purposes.
Document and disseminate information as appropriate.
Qualifications:
High School Diploma with a minimum of 3 years of trauma registry, coding and/or abstracting experience
OR a Graduate of an accredited record technician program
OR an Associate Degree with 1 year of trauma registry, coding and/or abstracting experience
Requires knowledge of medical record content, medical terminology, anatomy and physiology.
Requires prior experience in ICD-9 coding.
Desire abbreviated Injury Scoring (AIS).
Demonstrates experience in computer data entry, databases, and data retrieval is desirable
Licensure, Certifications, and Clearances:
Act 31 Child Abuse Reporting with renewal
Act 33 with renewal
Act 34 with renewal
Act 73 FBI Clearance with renewal
UPMC is an Equal Opportunity Employer/Disability/Veteran
Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services through efficient review and prompt resolution of assigned Medicare and third-party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. This position is 100% remote.
Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity Hold Codes in the hospital billing scrubber. Tasks associated with this work include resolving standard billing edits such as:
Correct Coding Initiative
Medically Unlikely Edits (MUE)
Medical Necessity edits
Other claim level edits as assigned.
As needed, review clinical documentation and diagnostic results as appropriate to confirm and apply applicable ICD-10, CPT, HCPCS codes and associated coding modifiers.
Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system
Ensures coding and billing practices follow Federal/State guidelines by using diverse types of authoritative information.
Maintains current knowledge of Medicare, Medicaid, and other third-party payer billing compliance guidelines and requirements.
Other duties equal with skills and experience as determined by the Director of Revenue Integrity.
What You Will Need:
High School Diploma/GED and 5+ years of prior relevant experience in lieu of diploma/GED
AAPC or AHIMA coding certification.
Experience in ICD-10, CPT and HCPCS Level II Coding.
Ability in determining medical necessity of services provided and charged based on provider/clinical documentation.
Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims.
Ability in determining accurate medical codes for diagnoses, procedures and services performed in the outpatient setting. For example: emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy
Knowledge of current code bundling rules and regulations along with ability on issues of compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG’s.
Knowledge and understanding of hospital charge description master coding systems and structures.
Ability to produce correct, assigned work product within specified periods.
What Would Be Nice to Have:
5 years’ experience in Revenue Integrity Coding and Billing
Hospital medical billing and auditing experience
Associate degree
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#LI- RemoteThe annual salary range for this position is $57,300.00-$85,900.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
About Guidehouse Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
The Hospitalist Pro Fee Coder must be proficient in surgical coding for Hospitalist providers. Coding Bedside procedures, critical care and Observation coding experience is also required. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines. This position is full time as and 100% remote.
What You Will Do:
• Demonstrates the ability to perform quality E/M coding and surgical as appropriate on assigned Hospitalist encounters. • Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing. • Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards. • Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility. • Ability to maintain average productivity standards as follows • Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary. • Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines. • Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met. • Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility. • Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request. • Responsible for coding or pending every chart placed in their queue within 24 hours. • It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard. • Coders are responsible for checking the Guidehouse email system at least every two hours during coding session. • Coders must maintain their current professional credentials while working for Guidehouse. • Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility. • Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy) • It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content. • Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services. • Communicates problems or coding principle discrepancies to their supervisor immediately. • Communication in emails should always be professional (reference e-mail policy).
What You Will Need:
High School Diploma/GED or 3 years of relevant equivalent experience in lieu of diploma/GED
3+ years of coding specific to the Hospitalist specialty including bedside procedures, critical care and Observation coding
AAPC Certification CPC
What Would Be Nice To Have:
AAPC Certification CEMC
Experience coding for Federal Government projects (DHA)
Multi-specialty coding experience
The annual salary range for this position is $0.00-$0.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
About Guidehouse
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
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