Outpatient Coder

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives

• Paid Certifications

• Tuition Reimbursement

• Comprehensive Benefits

• Career Advancement

• This position will pay between $19.75 - $24.20/hr based on experience

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The Outpatient Coder position reviews medical record documentation and accurately assigns ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA,) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications. Utilizing Coding Applications in accordance with established workflow. Follows Policies and Procedures and maintains required quality and productivity standards.

Job Responsibilities:

• Reviews medical record documentation and accurately assigns appropriate ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types (Ancillary, ED Charge/Code, Same Day Surgery, and Observation. The assigned codes must support the visit's reason and the medical necessity documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management, (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third-party software system such as LYNX.

• Correctly abstract required data per facility specifications.

• Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines.

• Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensure timely, compliant processing of outpatient claims in the billing system.

• Responsible for maintaining established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards.

• Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS,) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through.

• Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC,) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy.

Experience We Love:

• 1-3 years of previous of coding experience

• PC and Computer application knowledge and experience. Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).

• Excellent organization skills, communication, time management, trouble shooting and problem solving.

• Ability to multi-task and prioritize needs to meet short- and long-term timelines.

• Experience with EPIC and previous use of coding software tools.

Minimum Education:

• High School Diploma or GED

Required Certifications: Candidate must have and keep current at least one of the following professional certifications (CCS Preferred):

• CPC (Certified Professional Coder)

• CCS (Certified Coding Specialist)

• CCA (Certified Coding Associate)

• COC (Certified Outpatient Coder)

• RHIA (Registered Health Information Administrator)

• RHIT (Registered Health Information Technician)

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#LI-REMOTE

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• Innovation

• Work-Life Flexibility

• Leadership

• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits –  We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. 
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.  
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. 
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company. 

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws.  Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.

This posting addresses state specific requirements to provide pay transparency.  Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position.  A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

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