At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.
We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.
Job Title
Professional Fee Coder III (Fully Remote)
Location
Cleveland
Facility
Remote Location
Department
HVTI Business Office-Heart Vascular and Thoracic Institute
Job Code
U99930
Shift
Days
Schedule
9:00pm-4:00pm
Job Summary
Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.
As a Professional Fee Coder III, you will monitor, review, and apply correct coding principles to clinical information received from ambulatory areas for the purpose of reimbursement, research and compliance. You will identify and apply diagnosis codes, cot codes and modifiers as appropriately supported by the medical record in accordance with federal regulations. Lastly, you will ensure that billing discrepancies are met and corrected.
The ideal future caregiver is someone who:
•Has experience in coding.
•Is familiar with E/M coding guidelines.
•Has strong critical thinking and analytical skills.
•Pays close attention to detail.
This opportunity provides monthly coding education, reimbursement for addition coding education and certification and mentorship for those who want to grow into a leadership role.
At Cleveland Clinic, we know what matters most. That’s why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you’ll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you’ll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.
Job Details
Responsibilities:
- Compares and reconciles daily patient schedules/census/registration to billing and medical records documentation for accurate charge submission, which includes (but not limited to) processing of professional charges, facility charges, manual data entry.
- Maintains records to be used for reconciliation and charge follow up.
- Investigates and resolves charge errors.
- Meets coding deadlines to expedite the billing process and to facilitate data availability for CCF providers to ensure appropriate continuity of care.
- Responsible for working professional held claims in CCF claims processing system.
- Reviews, abstracts and processes services from surgical operative report.
- Reviews, communicates and processes physician attestation forms.
- Communicates with physician and other CCF departments (co-surgery) to resolve documentation discrepancies.
- Assists with Evaluation and Management (E&M) audits and other reimbursement reviews.
- Responsible for working E&M denials on the denial database.
- Other duties as assigned.
Education:
- High School Diploma / GED or equivalent required.
- Specific training related to CPT procedural coding and ICD9 CM diagnostic coding through continuing education programs/ seminars and/or community college.
- Working knowledge of human anatomy and physiology, disease processes and demonstrated knowledge of medical terminology.
Certifications:
- Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS-P), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA) or Certified Outpatient Coder (COC) by American Academy of Professional Coders is required and must be maintained.
Complexity of Work:
- Coding assessment relevant to the work may be required.
- Requires critical thinking and analytical skills, decisive judgment and work with minimal supervision.
- Requires excellent communication skills to be able to converse with the clinical staff.
- Applicant must be able to work under pressure to meet imposed deadlines and take appropriate actions.
Work Experience:
- Minimum of 3 years coding to include 1 year of complex coding experience in a health care environment and or medical office setting required.
- Must demonstrate and maintain accuracy and proficiency in coding and claims editing to be considered for a Professional Coder III position.
- Internal candidate must currently be employed as a Professional Coder II at the Cleveland Clinic or have met all the training, quality and productivity benchmarks of a Professional Coder II.
Physical Requirements:
- Typical physical demands involve prolonged sitting and/or traveling through various locations in the hospital and dexterity to accurately operate a data entry/PC keyboard.
- Manual dexterity required to locate and lift medical charts.
- Ability to work under stress and to meet imposed deadlines.