Professional Coder

Department/Unit:
Health Information Management

Work Shift:

Day (United States of America) Salary Range: $59,066.00 - $88,599.00

The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote.

Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met.

Review denials, research and respond appropriately and timely. Perform audits as determined by management. Assist with all levels of application testing for identified coding workflows as needed. Attend and contribute to all PCO staff meetings, department meetings and all other meetings assigned. Assume responsibility for professional development by participating in webinars, workshops, and conferences when appropriate. Ability to work well with people from different disciplines with varying degrees of business and technical expertise.

Remain knowledgeable of all insurance products (including Managed care, Medicaid and Medicare), policies and procedures as well as State and Federal mandates and legislation in relation to coding and documentation. Interact with providers and their staff to support accuracy and specificity in documentation and procedural and diagnostic coding. All other duties as assigned.

High School Diploma/G.E.D.

- required 1-3 years Experience in provider professional fee coding - preferred Working knowledge and experience with provider professional fee coding and charge processing. Computer experience, windows environment with proficiency in Microsoft Word and Excel is required. Excellent verbal and written communication skills. (High proficiency) CPC, CCA, CCS, COC, RHIT, RHIA or other coding credential through AHIMA or AAPC and be in good standing.

- required Equivalent combination of relevant education and experience may be substituted as appropriate.

Standing
- Occasionally Walking
- Occasionally Sitting
- Constantly Lifting
- Rarely Carrying
- Rarely Pushing
- Rarely Pulling
- Rarely Climbing
- Rarely Balancing
- Rarely Stooping
- Rarely Kneeling
- Rarely Crouching
- Rarely Crawling
- Rarely Reaching
- Rarely Handling
- Occasionally Grasping
- Occasionally Feeling
- Frequently Talking
- Frequently Hearing
- Frequently Repetitive Motions
- Frequently Eye/Hand/Foot Coordination
- Frequently Working

Extreme cold
- Rarely Extreme heat
- Rarely Humidity
- Rarely Wet
- Rarely Noise
- Occasionally Hazards
- Rarely Temperature Change
- Rarely Atmospheric Conditions
- Rarely Vibration
- Rarely

Thank you for your interest in Albany Med Health System! Albany Med Health System is an equal opportunity employer. This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose.…