• Pro Fee Medical Coder- E&M

    GuidehouseDenver, CO 80238

    Job #1514793320

  • Overview

    Guidehouse is a leading management consulting firm serving the public and commercial markets. We guide our clients forward towards new futures that build trust in society and your professional skills along the journey. Join us at Guidehouse.

    Responsibilities

    The Pro Fee Medical Coder- E&M must be proficient in E/M coding for all places of services. Will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager-the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.

    · Demonstrates the ability to perform quality coding on ancillary charts, clinic charts, and emergency room records.

    · Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding

    documentation and billing.

    · Assures that all services documented in the patient's chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented

    appropriately, seeks to attain proper documentation in a timely manner according to facility standards.

    · Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility.

    · Ability to maintain average productivity standards as follows

    · Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary.

    · Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines.

    · Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.

    · Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.

    · Provides accurate answers to physician's/hospitals coding and/or billing questions within eight hours of request.

    · Responsible for coding or pending every chart placed in their queue within 24 hours.

    · It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard.

    · Coders are responsible for checking the Guidehouse email system at least every two hours during coding session.

    · Coders must maintain their current professional credentials while working for Guidehouse.

    · Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility.

    · Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)

    · It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content.

    · Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.

    · Communicates problems or coding principle discrepancies to their supervisor immediately.

    · Communication in emails should always be professional (reference e-mail policy).

    Qualifications

    • Must be hold one of the following credentials: CPC, COC, CCS-P.

    • 3 years multi-specialty E/M coding experience.

    • Familiarity with 2021 E/M Guidelines

    • Must maintain credential thoughout employment

    • Must be able to work independently,multi task well and interface with all levels of personnel as well as clients

    • Abide by all client policies and procedures.

    • Abide by all Guidehouse policies and procedures.

    • Must have experience working in systems such as EPIC, Cerner, Next Gen, Allscripts or other EHR.

    • Excellent verbal, written adn interpersonal communication skils

    • Advanced knowledge of Excel, Word and Powerpoint

    • Strong working knowledge and experience with federal and state coding regulations and guidelines

    • Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.

    Additional Requirements

    The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

    Candidates from Eastern Standard Time, Central Standard Time, and Pacific Standard Time Zones as well as candidates from Arizona, New Mexico and Utah will be considered for this position.

    Disclaimer

    About Guidehouse

    Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

    Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

    If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at ~~~ or via email at ~~~. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

    Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

    Rewards and Benefits

    Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

    Benefits include:

    • Medical, Rx, Dental & Vision Insurance

    • Personal and Family Sick Time & Company Paid Holidays

    • Parental Leave and Adoption Assistance

    • 401(k) Retirement Plan

    • Basic Life & Voluntary Life Insurance

    • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

    • Short-Term & Long-Term Disability

    • Tuition Reimbursement, Personal Development & Learning Opportunities

    • Skills Development & Certifications

    • Employee Referral Program

    • Corporate Sponsored Events & Community Outreach

    • Position may be eligible for a discretionary variable incentive