Job Description
Job Title : Medical Hematology and Oncology Professional Coder
Job Summary
Reporting to the Director of Ambulatory Business Services, the Certified Coder Professional will be responsible for reviewing an evaluating clinical documentation within medical records to ensure high quality and compliant coding. The Certified Coder
Professional will provide training, consultation, and feedback to clinicians on their documentation and coding to ensure
Emanate Health Medical Group receives appropriate reimbursement and conforms to applicable guidelines and regulations.
Collaborates with Emanate Health’s Compliance team and with all third party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs. Serves as the coding subject matter expert for the physicians.
Job Requirements
a. Minimum Education Requirement :
Successful completion of a certified coding program from a nationally accredited medical coding organization. Certified Professional Coder Requirement
b. Minimum Experience Requirement :
Minimum of 2+ years of relevant professional coding experience in a health care clinic setting. Certified Professional Coder Requirement
Successful completion of a certified coding program from a nationally accredited medical coding organization. Credentials include but not limited to Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) license.
Preferred 3+ years of relevant professional coding experience in a healthcare clinic setting with experience in coding outpatient procedures and surgeries for various multi specialties. Strong knowledge of and experience with ICD-10 and CPT coding and thorough understanding of the effect of data quality on potential payment, utilization and reimbursement for multiple medical professional service specialties required. Understanding of ICD-10, CPT codes (including E&M leveling), HCPCS, modifiers, medical terminology and anatomy & physiology. Thorough understanding of data systems and reporting for health record coding, abstracting, and performance metrics required. Knowledge of and experience with Microsoft Office Suite required. Experience conducting training/educational sessions for professional staff including preparations of instructional materials preferred; experience with evaluating physician documentation, coding audits and quality performance preferred. The interpersonal skills necessary to interact effectively with physicians and physician office staff. The written and verbal skills necessary to develop training materials and provide training and feedback to physicians and staff. The ability to interpret documents such as encounter forms, medical records, physician documentation, lab reports, dictated reports, operating instructions and policy/procedure manuals. The ability to apply common sense understanding to carry out instructions furnished in written or oral form. The analytical skills necessary to solve practical problems involving several concrete variables in standardized situations and summarize findings. The ability to work a varied schedule including early or late hours as required along with site travel within the system.
c. Minimum License Requirement :
Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) license.
Job Overview
Reports To Director Ambulatory Business Services
Overtime Status Exempt - "Salary" Employee not eligible for overtime
Supervises No
Organizational Key Results Areas
Key Result Area Standards of Performance
Provides patients, customers, visitors and co-workers with courteous, informative and helpful services that adhere to appropriate etiquette.
Regularly displays a commitment to excellence, quality, safety and customer service. Strives to continually improve.
Affirms the rights, dignity, individuality and worth of each person Emanate Health serves and of each co-worker and understands, respects and values the cultural differences in our community`s population to effectively deliver quality, cost
Mission: Emanate Health efficient services. Makes those with different backgrounds and values feel at
exists to help people keep well ease.
in body, mind and spirit by providing quality health care Always checks at least two patient identifiers prior to performing any procedure or
services in a safe, administering any medication.
compassionate environment.
Demonstrates fairness and honesty and is guided by a high level of personal
Vision: We are an integral integrity and character that adheres to Emanate Health’s Code of Ethics.
partner in elevating our communities` health. Values: Consistently utilizes good judgment in the work place and takes responsibility for
Respect, Excellence, own actions.
Compassion, Integrity, and
Stewardship.
Demonstrates organization`s commitment to meet its fiscal and social responsibilities to the community (i.e., uses good judgment in the use of resources; demonstrates professional responsibility for customer service, patient rights, cost control and safety, etc., within the scope of job).
Effectively represents Emanate Health mission, vision and values in daily behavior and in interactions with patients and others. Holds oneself and others accountable to provide exceptional service.
Proactively offers assistance or help to fulfill our customer`s needs by referring customers to the appropriate resources. This includes giving clear directions and following the `No Point Policy` by escorting customers to their destination.
Demonstrates positive attitudes that exhibit care and compassion towards all customers and colleagues.
Uses verbal and non-verbal language that communicates respect and appreciation for customers and colleagues alike.
In any face to face interaction (seeing visitors or co-workers in the halls, at meetings, etc), makes eye contact, gives a friendly verbal greeting or acknowledgement and demonstrates a positive attitude.
Promptly responds to complaints by taking appropriate action(s) or referring complaint to appropriate resource to patient/customer`s satisfaction.
Customer Service
Takes pride and ownership in the appearance of the hospitals by maintaining a clean, quiet and attractive environment.
Demonstrates teamwork by helping one another to efficiently complete work and tasks and manages up team members to customers.
Adheres to the dress code policy by wearing clothes that are professional, clean and neat and always wear a readable name badge.
Conducts self in a professional manner. Is aware of what others may see and/or overhear.
Provides ongoing and easy to understand communication to customers and their families that keeps them informed as to progress and/or resolution.
Respects the feelings of others, is empathetic, demonstrates an attitude of caring and anticipates the needs of others.
Treats coworkers, patients and all other customers the way they themselves would want to be treated.
Consistently uses telephone courtesy by identifying themselves and their department to the caller, followed by an offer of assistance.
Uses Building Connections concepts in interactions with customers and colleagues to convey compassionate care.
Demonstrates understanding of the `power of apology` and uses it with customers and colleagues as appropriate.
Strives to be a problem fixer - not a finger-pointer.
Does not access, use or disclose PHI unless a current treating relationship or operational need exists.
Does not discuss one patient/customer with another patient/customer, employee or visitor.
Only shares patient/customer information with co-workers directly involved in the patient/customer's care.
Does not discuss a patient/customer or any patient/customer information in public areas (such as the elevator, cafeteria, hallways, etc.) or in a manner that can be
Confidentiality overheard by others.
Does not talk about co-workers with other employees, patient/customers or guests.
Does not discuss personal problems or internal information with patient/customers or guests.
Ensures that patient/customer and all other confidential information is secured at all times (i.e., patient/customer charts are closed, information is placed face down on desktops, computers are turned off or a screen saver is invoked, etc).
Demonstrates consistent vigilance in safeguarding all confidential data.
Manages interpersonal conflicts and resolves personal and process difficulties
Conflict Management efficiently and effectively.
If applicable, maintains licensure/certifications required for the position and renews them prior to their expiration date.
Accountability Meets deadlines and adheres to working hours.
Assumes responsibility for errors/failure to meet deadlines and takes immediate, appropriate steps to correct errors and/or improve time management.
Has met Emanate Health attendance and punctuality standards during the
Attendance and Punctuality evaluation period.
Job Specific Key Results Areas
Key Result Area Standards of Performance
Review and evaluate patient medical records to accurately assign diagnosis and procedure codes, and modifiers for professional coding.
Responsible for CPT and ICD-10 coding and ensuring accuracy for maximum reimbursement.
Duties
Works system coding edits, insurnace coding rejections and coding insurance denials in Practice Management and or EMR systems.
Analyzes documentation to identify any documentation deficiencies which may impact coding and provides supporting documentation that supports coding guidance and substantiate coding related payor appeals.
Extracts data from EMR system for abstract coding, interprets, and enters into
Practice Management system for billing purposes.
Determine the correct principal diagnosis, co-morbidities, complications, secondary conditions and surgical procedures.
Contacts site manager and or physician when documentation in the medical record is inadequate, ambiguous, or unclear for coding purposes.
Monitors regulatory and payer changes as they apply to diagnostic and procedure coding.
Maintains knowledge of the current changes of coding practices by continuing education and reading resource material.
Must maintain quality and production standards as set forth by the coding department.
Adheres to all Emanate Health Medical group standards, policies, and procedures.
Performs other duties as required.
Always attends required in-services and actively participates in self- education.
Performs Other Duties as Completes all job functions as per departmental policies and
Required procedures.
Maintains current knowledge in present areas of responsibility (i.e., attends ongoing educational programs).
Demonstrates responsibility for own standard of practice.
Demonstrates competency at all levels in providing care to all patients based on age, sex, weight and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age-specific customer service.
Job Type: Full-time
Pay: $30.00 - $40.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
- Work from home
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
- Clinic
- Hybrid work
- Medical office
- Office
Ability to Relocate:
- Covina, CA 91722: Relocate before starting work (Required)
Work Location: Hybrid remote in Covina, CA 91722