Remote Profee Multispecialty Coder

Remote Multispecialty Pro Fee Coder

Location: Remote (Remote Office Santa Fe, NM 87501)
Compensation: Pay Range:
Minimum Offer $24.27, Maximum Offer $41.33
Employment Type: Full time

Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote Multispecialty Pro Fee Coder to join our team.

• Implement and ensure compliance with enterprise‑wide and department coding policies and external regulatory coding rules.
• Perform and manage on‑site internal audits or reviews to assess compliance/quality monitoring, serving as a resource on documentation, coding, billing, and compliance questions.
• Develop and present educational programs, tools, and compliance projects for PHS/PMG departments.
• Support enterprise‑wide corrective action plans by auditing and training coding, audit, physician, and clinician personnel identified as low performers.
• Review denied and appealed claims, take appropriate action to ensure accurate payment, and coordinate the process with affected payers.
• Research and interpret regulatory agency regulations.
• Act as liaison to Management, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and ancillary departments for coding, auditing, compliance, and training issues.
• Maintain accurate, complete, and timely documentation in electronic or hard copy form.
• Adapt to changing work priorities and schedules.
• Maintain up‑to‑date technical knowledge of legal and regulatory information across relevant jurisdictions, including ICD‑9, ICD‑10, CPT‑4, HCPCS, and APC updates.
• Research coding, billing, and charging compliance issues, recommend and implement corrective action plans.
• Identify risks, develop, and follow up on action plans, uncover lost revenue opportunities, and address over payments due to coding or documentation errors.
• Assist in creating the CDQA Annual Audit Work‑plan using OIG, Medicare and Medicaid regulations, RAC, and other audit agency focuses.
• Exercise independent judgment in determining the reliability of data reviewed and recommend changes to improve compliance.
• Stay informed on the business climate of the healthcare industry.
• Respond to daily inquiries and requests regarding coding and auditing issues, performing ad‑hoc analysis for all PHS management.

• High school diploma or GED required.
• At least one of the following credentials: RHIT, RHIA, CPC, CCS.
• Minimum of three (3) years experience in coding and/or auditing.
• Audit experience preferred.
• Excellent written and verbal communication skills.
• Detail and results oriented.
• Ability to work independently and make autonomous decisions.
• Knowledge of medical terminology, ICD‑9, CPT‑4, and HCPCS.
• Proficient understanding of Medicare, Medicaid, and other third‑party payer documentation, coding and billing regulations for relevant service lines.
• Strong organizational and planning skills with ability to prioritize multiple tasks accurately.
• Computer skills:
  Microsoft Word, PowerPoint, Excel, internet research and resource applications.
• Ability to convey complex regulatory information in layman’s terms to all management levels.
• Integrity, honesty, and ability to inspire and motivate others.

• Comprehensive benefits package including medical, dental, vision, short‑term and long‑term disability, group term life insurance, and optional voluntary benefits.
• Employee Wellness rewards program offering gift cards and more for participating in wellness activities such as challenges, webinars, and preventive screenings.

AA/EOE/VET/DISABLED.