Logo for CGH Medical Center

Outpatient Coding Specialist, Remote

Role overview

Summary

This role focuses on reviewing and coding medical records to ensure accurate claims processing and compliance with coding guidelines. You will work within the Revenue Cycle at CGH Medical Center, contributing to the efficiency of billing and reimbursement processes.

Qualifications

  • CPC, CPC-A, CCS, CCS-P, CCA credential required.
  • Basic PC and PC maintenance skills required.
  • AHIMA CCA credential must be obtained within 2 years of hire if CPC or CPC-A certified.
  • Preferred: Coding experience in a medical center
  • Preferred: Working knowledge of regulatory requirements

Responsibilities

  • Review the contents of ancillary medical records to identify diagnoses for coding.
  • Utilize the encoder to assign ICD-10-CM codes according to guidelines.
  • Verify medical necessity criteria by reviewing encoder edits and CMS policies.
  • Participate in education and training as directed by the Coding Manager.

Key facts

Hard skills

Other skills

  • Communication
  • Detail Oriented
  • Problem Solving

About the company

CGH Medical Center logo

CGH Medical Center

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Our growth is creating great opportunities! Our team is growing and we want to hire the most talented people we can. Once you've had a chance to explore our current open positions, please apply to the one you feel best suits you! You can keep track of your progress in the selection process as well as stay updated on new positions that might interest you. 

Shift

Monday - Friday, Days

Scheduled Weekly Hours

40

POSITION PURPOSE:         

Reviews the contents of moderate to minimally complex medical records, assigns appropriate ICD-10-CM diagnosis, abstracts pertinent data for claims processing, data retrieval and analysis.  Abides by the Standards of Ethical Coding as set forth by the American Health Information Association and adheres to official coding and reporting guidelines, and hospital-specific guidelines. Maintains knowledge of pertinent federal regulations related to ancillary coding and reimbursement. 

ESSENTIAL FUNCTIONS:

  • Reviews the contents of the ancillary medical record to identify the diagnoses to be coded, ensuring that all conditions are properly documented and ordered by the provider and sequenced appropriately.
  • Utilizes the encoder to properly assign ICD-10-CM codes, adhering to the Uniform Hospital Discharge Data   Set Guidelines, the official coding and reporting guidelines, and Coding Clinic guidelines.
  • Verifies medical necessity criteria are met by reviewing encoder edits and review of CMS policies. Resolves potential medical necessity denials by review of physician documentation and orders in the electronic record.
  • Verifies specific charges in billing system (Cerner) to assure charging timeliness and accuracy.  Communicates with appropriate department manager, or designee of problems with charges.
  • Participates actively in the Revenue Cycle by monitoring the Prebill report to complete coding in a timely manner.
  • Participates in education and training as directed by Coding Manager.  Maintain coding credential through continuing education provided by CGHMC.

SPECIALIZED KNOW-HOW & REQUIREMENTS:

  • CPC, CPC-A, CCS, CCS-P, CCA credential required;  if CPC or CPC-A certified required to be AHIMA CCA credentialed within 2 years of hire.  For advancement to other coding positions such as Inpatient coding specialist or Outpatient Coding II Specialist, a CCS or CCS-P must be obtained within 2 years of hire for those positions.
  • Coding experience in a medical center preferred
  • Working knowledge of regulatory requirements, understanding of APC’s, modifiers and accounts receivables preferred.
  • Basic PC and PC maintenance skills required.

Compensation Range

$17.95 - $26.93

Available Benefits for Benefit Eligible Positions

Health and Dental Insurance

IMRF (Illinois Municipal Retirement Fund)

Retirement Fund (457 and 401A Plan)

Medical and Dependent Care Flexible Spending

Life Insurance

Short and Long Term Disability

Optional Insurances

Paid Time Off

Tuition Reimbursement and Loan Forgiveness

Gift Shop Discount

CGH Day Care Discount

CGH Dietary Discount

Employee Assistance Program

CGH Pharmacy Discount

CGH Vision Center Discount

Thank you for your interest in a career at CGH Medical Center.

Related jobs

See all Software Engineer jobs