Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
Job Summary:
The Medical Coder II reviews clinical documentation to code diagnoses for physician-based claims and data needs. For Radiation Oncology physician-based claims and data needs, the Coder I review’s clinical documentation to code diagnoses and, if applicable, E&M level. Additionally, this role also validates APC calculations, abstracts clinical data, mitigates diagnosis and, if applicable, E&M level coding-related claims scrubber edits, and may interact with client staff and providers.
Key Responsibilities:
- Verify and sequence ICD-10, and or CPT/HCPCS codes from patient medical records and or procedure reports for submission.
- Understanding of hierarchy coding for ICD-10 coding as it relates to official guidelines and linking.
- Knowledge and ability on how to apply column 1 and 2 rules for ICD-10 coding.
- Understanding of CMS guidelines and how to navigate and research LCD (LOCAL COVERAGE DETERMINATION) and NCD (National Coverage Determination).
- Individuals must be able to communicate clearly and precisely with providers during the querying process.
- Knowledge of Medicare, Managed Care and Commercial Insurance guidelines for coding E&M, and procedures.
- Ability to navigate electronic medical records as it relates to billing, coding, and insurance denials.
- Must be able to work denials for insurance follow-up and work collaboratively with Accounts Receivable Team.
- Coders are expected to review and submit sixty-four encounters per day or eight charts per hour, related to evaluation & management, procedures, testing, denials are five charts per hour.
- knowledge and understanding of insurance denials as it relates to accounts receivable.
- Must be comfortable working professional office, hospital outpatient and in-patient services.
- Participate in client and Savista staff meetings, trainings, and conference calls as requested and or required.
- Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols, and third-party requirements regarding coding and/or billing.
- Participate in continuing education activities to enhance knowledge, skills and maintain current credentials.
Minimum Qualifications:
- An active AHIMA (American Health Information Association) credential or an active AAPC (American Academy of Professional Coders) credential
- 3 years of relevant coding experience.
- Knowledge of medical terminology, anatomy and physiology, and ICD-10 and CPT/HCPCS code sets.
- Ability to consistently code at 95% threshold for quality and accuracy while maintaining client specific and/or Savista production and or quality standards.
- Proficient computer knowledge including MS Office with ability to enter data, sort and filter excel files, (Outlook, word and excel).
- Excellent interpersonal and problem-solving skills with all levels internal and external customers.
- Outstanding organization skills and time management required.
Preferred Skills:
- Recent and relevant experience in an active coding production environment strongly preferred.
- Experience utilizing and encoder system.
- EPIC and Cerner experience preferable.
- Proficient in ARIA system
Savista is required by state-specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $23 to $27. However, specific compensation for the role will vary within the above range based on many factors, including but not limited to geographic location, candidate experience, applicable certifications, and skills..
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
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