Edit Senior Coder

Job Summary

This position will be functioning under minimal supervision while utilizing independent decision making. This position will assist the manager and supervisor in training new team members, coordinate inquiries from ancillary departments regarding DNFB and edit tasks. The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts.

Include the following. Others may be assigned.

• Performs claim edit reviews on outpatient encounters to validate appropriateness of the CPT codes, HCPCS Level II codes, and modifier assignments, APC group appropriateness, review for missed secondary diagnoses and/or procedures, and ensure compliance with all APC mandates and outpatient reporting requirements. Monitors medical visit code selection by departments against facility specific criteria for appropriateness. Assists in the development of such criteria as needed.
  
  Addresses CCI and LCD edits within the various billing editors while abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association. Meets and/or exceeds Conifer’s Edit Coder productivity standards.
• Runs and submits coding operational reports to leadership as requested, reviews data and identifies opportunities or trends. Demonstrates working knowledge of DNFB and uses data to drive performance excellence. Ability to analyze, display, and communicate data in meaningful manner. Ability to maneuver thru various electronic systems effectively.
• Ability to deal with customer/partner issues and resolve conflict. Ability to multi-task and meet deadlines. Will act as a resource for Edit Coders.
• Reviews claim denials and utilizes the medical record in determining accurate code assignment of all documented diagnoses and procedures adhering to the standards of ethical coding.
• Monitors DNFB report for outstanding and/or uncoded encounters to ensure timeliness of coding completion. Brings identified issues to department managers for resolution.

• Three years minimum hospital outpatient coding/edit experience
• Advanced personal computing skills including MS Outlook, MS Word, MS Excel
• Advanced technical skills required to learn and navigate a variety of software systems, trouble‑shoot computer problems, and work efficiently in a virtual environment
• Strong written and verbal communication skills
• Ability to think/work independently, yet interact positively with team
• Advanced problem‑solving skills and ability to quickly analyze a situation.
• Comprehensive knowledge of ICD-10 and CPT coding systems.
• Strong knowledge base of changes in LCDs and NCDs.
• Strong knowledge base of current NCCI and OCE guidelines
• Attention to detail is critical to this position
• Other functions as deemed necessary to complete and final bill claims accurately

Required:

AHIMA RHIT or RHIA or AAPC CCS, CPC approved credential

• Ability to lift 15‑20lbs
• Ability to sit and work at a computer for a prolonged period of time
• Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments

• Office/Hospital Work Environment
• Works in a private office space in the coder’s home per Conifer Telecommuter Policy as defined in the Telecommuting Program Guide

Must be able to travel nationally as needed, not to exceed 10%

• Pay: $24.82 - $37.23 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending…