Pro Fee Medical Coder- Ear, Nose, and Throat at Guidehouse

Remote | Full-time
Guidehouse

Remote Pro Fee Medical Coder-ENT

Virtual, United States

Candidates from Eastern Standard Time, Central Standard Time, and Pacific Standard Time Zones as well as candidates from Arizona, New Mexico and Utah will be considered for this position.

Client Services

14211

Job Description

Overview

Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting. We help clients address their toughest challenges and navigate significant regulatory pressures with a focus on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that prepare our clients for future growth and success.

The company has more than 10,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies.

Responsibilities

The Pro Fee Medical Coder- ENT must be proficient in ENT coding for all places of services. Will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.

  • Demonstrates the ability to perform quality coding on ancillary charts and clinic charts.
  • Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing
  • Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards
  • Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility.
  • Ability to maintain average productivity standards
  • Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines
  • Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.
  • Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.
  • Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request
  • Responsible for coding or pending every chart placed in their queue within 24 hours.
  • It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard
  • Coders are responsible for checking the Guidehouse email system at least every two hours during coding session.
  • Coders must maintain their current professional credentials while working for Guidehouse
  • Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility
  • Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)
  • It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content
  • Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services
  • Communicates problems or coding principle discrepancies to their supervisor immediately.
  • Communication in emails should always be professional (reference e-mail policy).

Qualifications

Required:

  • Minimum 3-5 years previous ENT coding experience
  • Must hold the following credentials: CPC
  • Must maintain credential throughout employment
  • Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients
  • Excellent verbal, written and interpersonal communication skills
  • Strong knowledge of Excel, Word and PowerPoint
  • Strong working knowledge and experience with federal and state coding regulations and guidelines

Additional Requirements

  • The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

Remote Pro Fee Medical Coder-ENT

Atlanta, Georgia;

Virtual, United States

Candidates from Eastern Standard Time, Central Standard Time, and Pacific Standard Time Zones as well as candidates from Arizona, New Mexico and Utah will be considered for this position.

Client Services

14211

Job Description

Overview

Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting. We help clients address their toughest challenges and navigate significant regulatory pressures with a focus on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that prepare our clients for future growth and success.

The company has more than 10,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies.

Responsibilities

The Pro Fee Medical Coder- ENT must be proficient in ENT coding for all places of services. Will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.

  • Demonstrates the ability to perform quality coding on ancillary charts and clinic charts.
  • Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing
  • Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards
  • Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility.
  • Ability to maintain average productivity standards
  • Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines
  • Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.
  • Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.
  • Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request
  • Responsible for coding or pending every chart placed in their queue within 24 hours.
  • It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard
  • Coders are responsible for checking the Guidehouse email system at least every two hours during coding session.
  • Coders must maintain their current professional credentials while working for Guidehouse
  • Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility
  • Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)
  • It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content
  • Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services
  • Communicates problems or coding principle discrepancies to their supervisor immediately.
  • Communication in emails should always be professional (reference e-mail policy).

Qualifications

Required:

  • Minimum 3-5 years previous ENT coding experience
  • Must hold the following credentials: CPC
  • Must maintain credential throughout employment
  • Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients
  • Excellent verbal, written and interpersonal communication skills
  • Strong knowledge of Excel, Word and PowerPoint
  • Strong working knowledge and experience with federal and state coding regulations and guidelines

Additional Requirements

  • The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

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