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  • Full Time
  • India

HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients. At HealthRecon Connect, day after day, we not only hold ourselves accountable for setting and maintaining high standards, but we also passionately strive for the highest achievement, customer delight and thrive on the challenge of high expectations and commitment to excel.

HealthRecon was certified a Great Workplace by Great Place to Work® Sri Lanka for five consecutive years and was adjudged one of the 40 Best Workplaces in Sri Lanka in 2021. HealthRecon is also a Signatory Participant of the United Nations Global Compact.

We have exciting opportunities for ED Professional Coder to join our team. Please review the criteria and other information listed below thoroughly prior to applying and pay specific attention to the work week, shift details and other features of the job. Due to the large volume of applications we receive, all applications will be reviewed in the order in which they were received and only the candidates short-listed for the first round of interviews will be contacted. Thank you for your understanding.

Job Vacancy:
ED Professional Coder

Work Week:
Monday to Friday

Shift Window:
12:00 PM – 9:00 PM IST (Straddle Shift)
First month alone candidate must be willing to work in US shift hours for the training purpose.

Other Features:
Full-time
US calendar applicable

Key Responsibilities:

  • Review and analyze medical documentation for emergency department (ED) encounters to extract relevant information, such as diagnoses, procedures, and services rendered.
  • Assign appropriate ICD-10-CM, CPT, HCPCS, and other applicable codes to represent the services provided accurately.
  • Adhere to coding guidelines, including official coding guidelines, local coverage determinations, and other regulatory requirements.
  • Ensure compliance with relevant coding and documentation standards, such as the International Classification of Diseases (ICD) coding systems, Current Procedural Terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS), and any other coding guidelines specific to the facility or payer.
  • Collaborate with healthcare providers, physicians, and other relevant staff to clarify documentation and obtain additional information when necessary to support accurate coding.
  • Review medical records for completeness, accuracy, and consistency, and work with the clinical team to ensure proper documentation of diagnoses, procedures, and services.
  • Stay updated with changes in coding guidelines and regulations, attend relevant training and educational sessions to enhance coding skills and knowledge.
  • Participate in internal and external coding audits to assess coding accuracy, identify areas for improvement, and implement corrective actions as needed.
  • Collaborate with compliance and audit teams to address any coding-related issues or discrepancies.
  • Perform quality checks on coded data and claims to ensure compliance with coding standards and regulatory requirements.
    • Translating patient information into alpha-numeric medical codes using patient treatment, health history, diagnosis, and related information.
    • Assigns codes for diagnoses, treatments, and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
    • Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.
    • Able to accurately abstract information from the medial records into the abstract system, according to established guidelines.
    • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines.
    • Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (i.e.: NDC #, or number of units).
    • Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity.
    • Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns.
    • Meet and/or exceed the established coding productivity standards.
    • Effectively communicates with clinicians and billing/coding teams regarding code changes and denials.
    • Complete accountable work related to daily unbilled charges to ensure timely billing in conjunction with billing and compliance guidelines.
    • Address appeals and review documentation needed for insurance denials to facilitate expedient resolution and reimbursement.

 

Qualifications/Criteria:

  • Certified Professional Coder (CPC) or equivalent medical coding certification (e.g., CCS-P).
    • At least 2 years of coding experience.
  • Strong knowledge of ICD-10-CM, CPT, HCPCS, and other relevant coding systems and guidelines.
  • Familiarity with emergency department procedures, terminology, and common diagnoses.
  • Proficient in using coding software and Electronic Health Record (EHR) systems.
  • Excellent attention to detail and analytical skills.
  • Strong understanding of medical terminology, anatomy, and physiology.
  • Knowledge of reimbursement methodologies, including Medicare and Medicaid guidelines.
  • Ability to interpret and analyze complex medical records and documentation.
  • Strong communication skills to effectively collaborate with various stakeholders.
  • Incumbents must be proficient with CPT and ICD-10-CM coding systems and responsible for assigning ICD-10-CM diagnoses codes and CPT procedure codes accurately and completely to ensure optimal reimbursement and coding quality. Coders in this position are held accountable for adhering to coding guidelines; accounts must be coded within the quality and productivity standards specified by department leadership.
  • Incumbent is responsible for abstracting, analyzing, and assigning ICD-10-CM, CPT, HCPCS codes and appropriate modifiers for evaluation and management (E/M), minor procedures, and diagnostic tests by using either computerized or manual systems. Researches and resolves coding and reimbursement issues to ensure the accuracy, quality, and integrity of coding practices.

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