Coder, Medical Billing and Coding, Healthcare Administration

Job Overview

Fairview is looking for a seasoned Coder 3 who enjoys tackling complex outpatient cases and working at the top of their expertise. In this fully remote role, you’ll use your advanced knowledge of ICD-10-CM, CPT-4, and HCPCS to confidently code specialty and hospital-based accounts, assign APC weights, resolve medical necessity edits, and navigate nuanced coding scenarios using encoder and CAC technology.

Your precision will directly influence reimbursement, quality reporting, compliance, and the integrity of healthcare data across the organization. This is a full-time (1.0 FTE, 80 hours per pay period) day shift position with just one weekend day per month—offering meaningful, high-impact work with the flexibility of working from home.

• Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
• Actively participates in creating and implementing workflow improvements.
• Assigns ICD-10-CM, CPT-4, or HCPCS codes to all diagnoses, treatments, and procedures on complex hospital outpatient or clinical department visits.
• Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned.
• Is able to research and understand simple and moderately complex coding issues.
• Is proficient in using various coding software. Is able to problem solve simple computer issues.
• Utilizes technical coding principles and/or APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT-4 procedures. Assigns modifiers to CPT codes.
• Extracts required information from electronic medical record and enters into coding software and abstracting system.
• If applicable, identifies chargeable items for department visits and enters into computer system.
• Follows-up on unabstracted accounts to assure timely billing and reimbursement.
• Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication.
• May query physicians on documentation according to established procedures and guidelines.
• Meets productivity and quality standards as established by coding managers.
• Educate multidisciplinary team members, including physicians, about frequently changing mandated rules, regulations and guidelines to ensure a compliant claim.
• Identify and/or resolve clinical documentation and charge capture data discrepancies to improve quality of the clinical documentation, complexity of reimbursement levels assigned, and integrity of data reported.
• Performs other responsibilities as needed/assigned.
• Timely and accurate work.
• Contributes to the process or enablement of collecting expected payment.
• Understands and adheres to Revenue Cycle’s Escalation Policy.
• Organization Expectations, as applicable:
  Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served; partners with patient caregiver in care/decision making; communicates in a respectful manner; ensures a safe, secure environment; individualizes plan of care to meet patient needs; modifies clinical interventions based on population served; provides patient education based on assessment of learning needs of patient/caregiver;
  
  fulfills all organizational requirements; completes all required learning relevant to the role; fosters a culture of improvement, efficiency and innovative thinking.
• Performs other duties as assigned.

• Education
  :
  Completion of an accredited coding certificate program or a Health Information Technician program.
• Experience
  : 2 years of coding experience.
• Certification
  :
  One of the following is required for hire: RHIA, RHIT, CCS, CPC, CCS‑P, CPC‑H, COC, or AAPC specialty certifications.

• Associate of Science in Health Information
• Bachelor of Science in Health Information
• 2 years of coding experience with a variety of professional and hospital accounts – e.g., Observation, Surgical outpatients, Interventional Radiology, Heart Catheterization, Professional billing surgical specialty.
• Outpatient or Professional Fee Coding: RHIA, RHIT, CCS, CPC, CCS‑P, CPC‑H, COC, or other…