Remote ED/Claim Edit Coder

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<h2>Overview</h2> <p>Presbyterian is seeking a talented <strong>Remote ED/Claim Edit Coder</strong></p> <p> </p> <p>Has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate <strong>coding expertise</strong> in a specific specialty deemed a critical business need by PHS Coding Leadership using the <strong>ICD-9/10 CM and CPT-4</strong> classification system. Ensures adherence to Hospital and Departmental Policies and Procedures</p> <ul> <li>Full Time - Exempt: No</li> <li>Rev Hugh Cooper Admin Center</li> <li>Work hours: Varied Days and Hours</li> <li>Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.</li> </ul> <p><strong>Ideal Candidate: </strong><strong>Must have any one of the following coding certifications at time of hire: CCS, CCS-P, COC, or RHIT/RHIA.  Inpatient Coding experience </strong></p> <h2>Qualifications</h2> <ul> <li>High school diploma/GED required.</li> <li>Must have any one of the following coding certifications at time of hire: CCS, CCS-P, CPC-H, or RHIT/RHIA with achievement of one of the coding credentials above within one year of hire.</li> <li>Three to five years experience as a coder required.</li> </ul> <h2>Responsibilities</h2> <ul> <li>Must demonstrate knowledge of coding multiple areas of service and/or specialties or extensive experience in a specific specialty deemed a critical business need by PHS Coding Leadership.</li> <li>Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.</li> <li>Accesses several systems via the computer to research the medical record when needed to complete the coding in a timely manner.</li> <li>Takes responsibility for accounts receivable by looking for lost documents to insure all encounters are coded, including the generation of appropriate queries, as needed.</li> <li>Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9/10 CM, CPT-4, HCPCS, and DRG, APC and/or HHRG updates and changes.</li> <li>Responsible for resolving any and all pre-bill edits, denials, etc. for assigned accounts.</li> <li>Participates in all departmental in-services and updates to stay current with the accepted coding guidelines and improve personal knowledge of medicine and treatment.</li> <li>Performs other functions as required.</li> </ul> <h2>Benefits</h2> <p><strong>About Presbyterian Healthcare Services </strong>Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.</p> <p>The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives.</p> <p>As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.</p> <p><em>AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</em></p> <h2>Maximum Offer for this position is up to</h2>USD $35.29/Hr. <h2>Compensation Disclaimer</h2>The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

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