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Remote, USA, United States of America
Remote only
R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.
Position Summary:
Applies CPT-4 and HCPCS codes to medical records for the cardiovascular lab and interventional radiology departments based on documentation provided by physicians. Adheres to strict federal coding rules and guidelines in selecting codes that appropriately reflect the services that were provided. Balances need for (95% accuracy) coding accuracy against timely account completion for billing deadlines.
Essential Responsibilities:
Coding of surgical procedures performed by cardiologists, and interventional radiologists
Verification of supplies used during procedures
Use of encoders and other references
Maintains appropriate non-leading queries to physicians
Ability to abstract services from physician documentation and procedure logs.
Reconciliation of monthly surgical logs
Managing multiple job tasks daily (WQs, emails, surgical logs, census, etc.)
Prepares Excel analysis, including V-Lookups and pivot tables. Gathers and compiles data in a systematic fashion, clearly documenting assumptions, and validating accuracy of information to resolve inconsistencies.
Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and pricing, ensuring alignment with clinical services and coding/billing guidelines.
Conducts Charge Capture Audits: Review and analyze patient records, billing data, and financial statements to ensure charge and coding compliance. Identify discrepancies or errors and develop action plan for future state resolution
Analyzes data to identify likely relationships, summarizes data and prepares summary materials for discussion with clinical and finance teams.
Collaborates with various departments to resolve CDM or RI discrepancies (Utilization Management (UM), Clinical Documentation Integrity (CDI), RCM, Coding Services, Clinical Departments, and Health Information Management (HIM)).
Skills:
1. Advanced Knowledge: CPT/HCPCS, NCCI, and MUE.
2. Excel Proficiency: Strong skills in V-Lookups and pivot tables.
3. Analytical Skills: Systematic data gathering, compilation, and validation.
4. Attention to Detail: Accurate documentation and data accuracy.
5. Revenue Knowledge: Understanding of billing and revenue recognition.
6. Audit Skills: Conducting charge capture audits and identifying discrepancies.
7. Data Analysis: Analyzing data and summarizing findings.
8. Reporting: Running and extracting accurate reports.
9. Collaboration:** Working with various departments (UM, CDI, RCM, etc.).
10. Committee Participation:
11. Communication: Strong verbal and written skills.
12. Problem-Solving: Developing action plans for discrepancies.
13. Stakeholder Management: Interacting with stakeholders (Senior Leadership).
Other Qualifications:
Proficient computer skills (including, but not limited to, spreadsheets, Internet, and email) are required.
Proficiency in Excel, including V-Lookups and pivot tables.
Strong analytical and data validation skills.
Knowledge of billing and revenue recognition processes.
Experience in conducting charge capture audits.
Ability to analyze data, identify relationships, and summarize findings.
Experience with report extraction from software tools.
Excellent collaboration and communication skills.
Ability to work with various departments.
Experience interacting with executive stakeholders.
Education and Experience
Experience Level
4-6 years experience
License and Certification Level
Required Certification: CCS, CIRCC, COC, CPC or equivalent
The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.
Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.
R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s 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.
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To learn more, visit: R1RCM.com
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