Professional Coder III AHWFB

Department:02409 WFBMG University Group Practice: WFBMC Main - Surgery: Plastic and Reconstruction

Status: Full time

Benefits Eligible:Yes

Hours Per Week:40

Schedule Details/Additional Information:

Employee will be hybrid, Monday- Friday 8:00am-5:00pm

JOB SUMMARY:

Under limited supervision, abstracts and codes hospital based, inpatient hospital, outpatient and ambulatory physician (and mid-level provider) services and special procedures (e.g., Emergency Room, Ambulatory Surgery, Day Hospital, Sticht Center, Forsyth Hospital). Uses standard ICD diagnosis and CPT professional coding guidelines, Medicare, Medicaid and other third party regulations/requirements, as well as internal coding guidelines, in order to provide data for billing and reimbursement. This classification is intended for the most highly experienced and competent coding personnel.

EDUCATION/EXPERIENCE:

Graduation from an accredited medical coding program and three years of medical coding experience in a similar environment.

LICENSURE, CERTIFICATION, and/or REGISTRATION:

National coding certification (CPC or CCS).

ESSENTIAL FUNCTIONS:

1. Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading medical record documentation to assign and sequence diagnoses and procedure codes according to coding guidelines, and enter into the electronic system: a. Appropriate diagnoses codes, professional service codes and modifiers and/or facility service codes. b. Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules.

2. Maintains a current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for unlisted or unusual CPT codes), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures.

3. Accrues sufficient continuing education hours to maintain national coding certification.

4. Serves as a resource for less experienced medical coders.

5. Works collaboratively with team members, Corporate Revenue Cycle and Compliance Analysts to answer questions and/or resolve issues related to documentation, coding and billing of professional services and/or facility services.

6. Provides physician education to ensure documentation is sufficient for greatest accuracy of coding.

7. Resolves pending charges in the WakeOne coding work queues including claim denial work queues.

8. Responsible for researching specific questions/issues or conducting special projects as assigned.

9. Serves as a resource and/or participate in quality control functions such as assisting in audits of the departmental coding section.

10. Performs other related duties incidental to the work described herein.

SKILLS/QUALIFICATIONS:

Experience in coding of physician professional services in a teaching environment Familiarity with Medicare Teaching Physician Rules Familiarity with facility fee services within a Provider Based clinic Ability to meet and maintain performance standards of quality and productivity for Level III Coder by department Good oral communication skills Ability to provide guidance to others (if applicable)

WORK ENVIRONMENT:

Clean, well-lit and comfortable environment Quiet work area

Same Posting Description for Internal and External Candidates

Pay Range$28.05 - $45.25

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

Premium pay such as shift, on call, and more based on a teammate's job

Incentive pay for select positions

Opportunity for annual increases based on performance

Benefits and more

Paid Time Off programs

Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

Flexible Spending Accounts for eligible health care and dependent care expenses

Family benefits such as adoption assistance and paid parental leave

Defined contribution retirement plans with employer match and other financial wellness programs

Educational Assistance Program

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

R168636