Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Ortho Surgery Pro Fee Coder must be proficient in surgical coding for Ortho surgery cases. E/M experience is also required. The coder 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. This position is full time and 100% remote.

Responsibilities:

• Demonstrates the ability to perform quality surgical coding on Ortho surgery along with E/M as assigned.
• 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.
• Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary.
• 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.
• 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.
• 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.
 

What You Will Need:

• High School Diploma and 5+ years of prior relevant experience (relevant experience may be substituted for formal education)
• 3-5 years physician coding experience, both inpatient and outpatient coding for physician claims.
• 2-3 years coding ortho surgical procedures
• CPC certification from AAPC
• Electronic Medical Record experience
• 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.
• Must be able to demonstrate written and interpersonal communication skills.
• Must have knowledge of Excel, Word, and PowerPoint
• Must maintain accuracy of 95%
• Must have a working knowledge & experience with federal & state coding regulations and guidelines

What Would Be Nice to Have:

• COSC credential from AAPC
• Multiple EMR and/or practice management systems experience
• E/M experience along with surgical coding experience (Office, OP and OR procedures

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The annual salary range for this position is $49,400.00-$74,200.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.