Compares and reconciles daily patient schedules, census, and registration to billing and medical records documentation for accurate charge submission, which includes processing of professional charges, facility charges, manual data entry. Investigates and resolves charge errors. Meets coding deadlines to expedite the billing process and to facilitate data availability for CCF providers to ensure appropriate continuity of care. Works held claims and claim edits in the CCF claims processing system... more details
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Job Title
Professional Fee Coder II-Laboratory/Pathology
Location
Cleveland
Facility
Cleveland Clinic Main Campus
Department
HIM Coding-Finance
Job Code
U99931
Shift
Days
Schedule
6:00am-2:30am/9:00am-5:30pm
Job Summary
Job Details
Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.
As a Professional Fee Coder II, your primary duties include, but are not limited to:
• Monitoring, reviewing, and applying correct coding principles to clinical information received from ambulatory areas for reimbursement, research, and compliance.
• Identifying and applying diagnosis codes, cot codes, and modifiers as appropriately supported by the medical record in accordance with federal guidelines.
• Ensuring that billing discrepancies are met and corrected.
The ideal future caregiver is someone who:
• Has coding experience.
• Demonstrates a strong work ethic.
• Has strong critical thinking, communication, and analytical skills.
• Is technologically proficient.
This is an excellent opportunity for someone who seeks to enhance their coding skills while working remotely.
At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.
Responsibilities:
- Compares and reconciles daily patient schedules, census, and registration to billing and medical records documentation for accurate charge submission, which includes processing of professional charges, facility charges, manual data entry. Investigates and resolves charge errors.
- Meets coding deadlines to expedite the billing process and to facilitate data availability for CCF providers to ensure appropriate continuity of care.
- Works held claims and claim edits in the CCF claims processing system. Work accounts in the CCF claims processing system.
- Maintains proficiency in related CCF billing systems, productivity standards, and records to be used for reconciliation and charge follow up. Utilize ICD#9, ICD#10 and CPT-4 coding systems and materials.
- Maintains current knowledge and skills through reading and utilizing coding resources. Attends and participates in coding education systems.
- Reviews the Medication Administration Report (MAR) in the medical record for medications Hydration, Infusions, and Injections (HII) charged during observation time. Know the resources for the HII hierarchy.
- Other duties as assigned.
Education:
- High School Diploma / GED or equivalent required.
- Specific training related to CPC procedural coding and ICD9, ICD10 diagnostic coding through continuing education programs/seminars and/or community college.
- Working knowledge of human anatomy and physiology, disease processes and demonstrated knowledge of medical terminology.
Certifications:
- Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS-P), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA) or Certified Outpatient Coder (COC) by American Academy of Professional Coders is required and must be maintained.
- Existing CCF employees credentialed with CMC may be required to obtain CPC (or CCS-P, RHIT, or CCA) within 12 months.
Complexity of Work:
- Coding assessment relevant to the work may be required.
- Requires critical thinking and analytical skills, decisive judgment and work with minimal supervision.
- Applicant must be able to work under pressure to meet imposed deadlines and take appropriate actions.
Work Experience:
- Minimum of 2 years of coding experience in a health care environment and or medical office setting required.
- Internal candidate must currently be employed as a Professional Fee Coder I at the Cleveland Clinic or have met all the training, quality and productivity benchmarks of Professional Fee Coder I for six months to apply for a Professional Fee Coder II position.
Physical Requirements:
- Typical physical demands involve prolonged sitting and/or traveling through various locations in the hospital and dexterity to accurately operate a data entry/PC keyboard.
- Manual dexterity required to locate and lift medical charts.
- Ability to work under stress and to meet imposed deadlines.
Personal Protective Equipment:
- Follows Standard Precautions using personal protective equipment as required for procedures.
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster.
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
