Revenue Integrity Coder

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The Revenue Integrity Coder determines charges for outpatient departments, inpatient, split bill and hybrid clinics, including Pardee Urgent Care charges and coding. The coder works collaboratively with Patient Financial Services, the Billing Office, clinical and other departments to ensure timely revenue capture.

• Maintain a thorough understanding of hospital outpatient and physician billing requirements, including RVU, modifiers, and continuing education for charging and coding changes.
• Interpret usage of HCPCS and CPT codes, research NDC and NCCI review for compliant billing, assign and verify accurate use of modifiers when clearing work queues, and follow the Revenue Integrity workflow.
• Ensure compliance with federal and state rules by reviewing CMS and Palmetto GBA daily transmittals for any changes or new issues regarding charge and coding and patient charge rules.
• Review Urgent Care, Workers Comp and occupational medicine encounters for the Pardee Urgent Care Centers, verify documentation, E&M level, procedures performed, medications administered, and diagnosis codes, and query providers when documentation is in question.
• Review Emergency and Observation patient charts, Outpatient Ambulatory, OB Triage, and Extended Recovery patient charges on a daily basis, determine charges for split bill clinics, and clear the accounts accurately and on a daily basis.
• Keys in corrections to patient accounts based on Department Director requests and patient account error analysis through Epic, reviews coding and charging edits, and assists the billing office and HIM to resolve billing issues and denials that are coding and CPT/HCPCS related.

• High school diploma or equivalent.
• Certified Professional Coder (CPC) or Certified Coding Specialist from AAPC or AHIMA.
• Two (2) years of experience working in a charging and coding role.
• Experience working in healthcare/hospital related charge master maintenance and billing functions.
• Proficiency with Microsoft Excel or other spreadsheet software.
• Demonstrated experience researching LCD, NCD and NCCI.

• Experience with EPIC electronic medical recordkeeping (EMR) system.

Legal

Employer:

Pardee - HCHC
Entity:
Pardee UNC Health Care
Organization Unit:
Health Information Management
Work Type:
Full Time
Standard Hours Per Week: 40.00
Work Assignment Type:
Onsite

Work Schedule:

Day Job
Location of Job: PARDEEHOSP
Exempt From Overtime:
Exempt:
No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

Entry level

Full-time

Engineering and Information Technology

Wellness and Fitness Services, Hospitals and Health Care, and Medical Practices