Professional Coder II AHWFB

Department : Wake Forest Baptist Medical Center - Lab : Pathology Billing

Status : Full time

Benefits Eligible : Yes

Hours Per Week : 40

Schedule : Full-time remote, first shift, Monday through Friday. No weekends or holidays.

Pay Range : $26.10 - $39.15

Education / Experience : High school diploma or GED equivalent with two years of medical coding experience in a similar environment, or eligibility for internal promotion based on achieving and maintaining Coder level II performance criteria by department for six consecutive months.

Licensure, Certification, and / or Registration : National coding certification (CPC or CCS).

ESSENTIAL FUNCTIONS

• Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading and / or reviewing 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 / charge codes. b. Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules.
• 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.
• Accrues sufficient continuing education hours to maintain national coding certification.
• Serves as a resource for less experienced medical coders.
• 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.
• Provides physician education to ensure documentation is sufficient for greatest accuracy of coding.
• Resolves pending charges in the WakeOne coding work queues including claim denial work queues.
• Performs other related duties incidental to the work described herein.

SKILLS / QUALIFICATIONS

WORK ENVIRONMENT

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

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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.

Position Summary

Under general 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.

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