Coder - Professional

About the Opportunity

It is more than a career, it is a calling. MO-REMOTE Coder I, Professional at SSM Health. You will play a crucial role in ensuring accurate and timely coding of medical records. This is a remote position, allowing you to work from home while contributing to the success of our organization. Remote work is eligible in accordance with SSM policies; candidates must reside in MO, IL, OK, or WI (additional states may be considered).

Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures.

• Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture.
• Accurately deciphers charge error reasons and plans follow-up steps.
• Identifies all billable services.
• Reviews all applicable data sources, including electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs, nursing home visit documentation, procedure reports generated from non-electronic health record systems, and more.
• Reviews medical record documentation in the electronic health record and/or on paper.
• Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record.
• Identifies need for medical records from outside the organization and follows established procedures to obtain them.
• Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines.
• Consults with physicians/providers as needed to clarify documentation that is inadequate, ambiguous, or unclear for coding purposes.
• Provides education around documentation improvement for maximum patient care.
• Assists physicians/providers with questions regarding coding and documentation guidelines.
• Provides ongoing feedback based on observations from coding physician/provider documentation.
• Identifies opportunities for education and communicates trends to leaders.
• Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow-up denials.
• Works to improve billing based on findings or resolution of errors.
• Is watchful for charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement.
• Manages assigned charge review, claim edit, and coding follow-up work queues.
• Performs other duties as assigned.

High school diploma or equivalent.

Professional license and/or certifications may be required.

State requirements:
Illinois, Missouri, Oklahoma, Wisconsin.

• Certified Coding Associate (CCA) – AHIMA
• Certified Coding Specialist – Physician-Base (CCS-P) – AHIMA
• Certified Outpatient Coder (COC) – AAPC
• Certified Professional Coder (CPC) – AAPC
• Registered Health Information Administrator (RHIA) – AHIMA
• Registered Health Information Technician (RHIT) – AHIMA
• Certified Professional Coder Apprentice (CPC-A) – AAPC
• Certified Coding Specialist (CCS) – AHIMA

Day shift. Weekly hours: 40.

• Paid parental leave: one week for newborns or newly adopted children, pro-rated based on full-time equivalent.
• Flexible payment options: eligible hourly team members may access earned, unpaid base pay before payday through Daily Pay (fees may apply).
• Up-front tuition coverage: eligible team members receive coverage through Flex Path.

SSM Health is an equal-opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.