Pro-Fee Coder - General Surgical

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

The Coding Specialist II will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of professional billing and reimbursement. The Coder II will use standard ICD-CM and CPT professional coding guidelines, CMS, third party payer and/or client specific coding guidelines. The Coder II may interact with client staff and providers.

JOB ACCOUNTABILITIES:

•  Review provider charges and/or select and sequence ICD-10-CM, CPT, HCPCS and modifiers for ambulatory visits and procedures, Emergency Department visits and procedures, observation, outpatient and inpatient hospital professional services, bedside procedures, ancillary procedures and/or simple surgical coding (including but not limited to E&M visits, diagnostic tests, point of care tests, in-office procedures, injections/ infusions, non-operating room or simple surgical procedures).

• Review clinical documentation to ensure it substantiates professional charges and create professional, effective and compliant queries directed to providers and/or other clinical staff when existing documentation is unclear or ambiguous.

• Using correct coding guidelines and/or client specific guidelines, review and edit charges appropriately to resolve claim edits and coding related denials.

• Researches specific questions/issues or conducts special projects as assigned.

• Participates in training and/or auditing other coding colleagues and acts as a mentor when assigned.

• Serves as a subject matter expert and represents the client in meetings and/or on committees as requested.

• Manual data entry of charges into EMR as needed.

• Complete assigned work functions utilizing appropriate resources.

• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.

• Maintain strict patient and provider confidentiality in compliance with HIPPA

• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.

• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.

• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
• Support Savista’s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying …