Professional Coder IV, Days

Overview

At Atrium Health Wake Forest Baptist, we take pride in offering a dynamic and fulfilling work environment. Joining our team means becoming an essential part of a leading healthcare institution that is committed to providing exceptional patient care and advancing medical research.

Position Highlights: 

• Shift Schedule: Full time (40 hours), 
• Department:  Profee Coding
• Location:  Remote

What We Offer:

• Day 1 Health Coverage: Amazing health insurance with the option of copay or HSA eligible plans
• Wellness Incentives: Up to $1,350/year in wellness incentives through our LiveWELL program
• Education: Eligible for our Prepaid College Tuition Assistance program (up to $5,250/year)!
• Parental Benefits: Six weeks paid birthing-mother maternity leave & four weeks paid parental leave
• Retirement: Up to 7% employer-paid retirement contributions

Education/Experience/Certifications to Qualify: 

• Graduation from an accredited medical coding program and three years' experience in a professional coding setting; or an equivalent combination of education and experience. 
• One year multiple specialty and/or patient type coding experience preferred. Epic Super User training preferred and required within 12 months of hire. 
• General knowledge of anatomy and physiology and medical terminology required with completion of college level courses preferred. 
• Medical coding certification is required through AAPC, AHIMA or other professional coding societies. Specialty coding credentials preferred. 

Essential Functions: 

• Works collaboratively with coding manager in process management/improvement. 
• Assists coding manager with team productivity and quality audit reporting. 
• Researches and responds to questions from team coders. 
• Codes records maintaining established departmental accuracy and productivity standards. 
• Identifies, assigns and appropriately sequences accurate diagnoses, procedural, and E/M codes. Applies correct ICD, CPT and HCPCS guidelines and regulatory requirements as per departmental policy regarding compliant methods, timeframes, productivity and quality standards, and use of applications. 
• Assists in demonstrating medical necessity for procedures and services performed by ensuring that all documented disease processes are coded. 
• Abides by the AAPC Code of Ethics and/or the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines. 
• Reviews and/or edits ICD, CPT and HCPCS codes that substantiate providers professional services for inpatient or ambulatory health records including ambulatory, ancillary and OR surgery, emergent and urgent care, observation, and clinic records and other work as assigned, maintaining established departmental accuracy and productivity standards. Data reported is used to meet licensure requirements, statistical purposes, and for financial and billing purposes. 
• Reviews and/or edits professional services to reflect accurately provider documentation according to regulatory, payer, and professional guidelines. 
• Applies necessary coding guidelines to permit claims processing in charge review, coding denial and/or claim edit work queues. 
• Resolves moderately-significantly complex coding and billing issues, and resolves pending charges in the WakeOne coding work queues assigned. 
• Functions at an expert coder level and participates in auditing, training, and re-training of coders as directed. 
• Interfaces with other departments as needed and provides excellent customer service. 
• Participates in on site and/or external training workshops as opportunities arise. 
• Maintains credentials, if applicable, and submits written evidence of maintenance. 
• Performs other related duties as requested by Manager.