Professional Coder II

Cleveland Clinic Cleveland , OH 44114

Posted 2 months ago

Job Details While these positions offer the opportunity to work from home, we will only consider Ohio residents at this time. This position is posted as an Evergreen. You are submitting your application for a Professional Fee Coder II position with our Pro Coding Operations area. Areas of business that we support are the following: Medicine, Pediatrics, Head & Neck, Digestive Disease Surgery, Endocrinology and Metabolism, Dermatology and Plastic Surgery, Ortho and Rheumatology, Urology and Kidney, Regional Operations, Anesthesia, Center for Connected Care, Surgical Operations, Imaging, Respiratory and Cancer.


  • 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.

  • 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.

  • Other duties as assigned.


  • 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.


  • 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.

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.

  • 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.


Keywords: HIM, Health Information, Health Information Management Coder, Medical Coder, Coding Clinical Coder, ICD-10, ICD-9, RHIA, RHIT, CCS, CCS-P, CPC, CCA

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Certified Professional Coder HmsColumbus Full Time Days


Posted 1 week ago

VIEW JOBS 4/6/2021 12:00:00 AM 2021-07-05T00:00 At Paramount, we offer insurance to both large and small groups and also cater to Medicare (Paramount Elite) subscribers in northwest Ohio and southeast Michigan. Our Medicaid product (Paramount Advantage) services those living in the state of Ohio. We maintain an accreditation by the NCQA - the National Committee for Quality Assurance - for our Ohio HMO, Elite and Advantage products. We're also part of ProMedica, which is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest. For more information about Paramount, please visit our website Position Summary Employee is a certified coder who assists in and provides support for HMS' provider bill processing operations to ensure appropriate provider payments are made in compliance with HMS/Ohio Bureau of Workers' Compensation contract and the procedures set forth in the MCO Policy Reference Guide. Employee must utilize certification expertise to assess complicated coding and billing issues. Accountabilities 1. Understands and complies with Ohio BWC Guidelines as set forth in the MCO Policy Reference Guide and Ohio BWC Billing and Reimbursement Manual. 2. Completes prospective, concurrent and retrospective reviews for inpatient hospital admissions. 3. Audits provider bills for accurate coding. 4. Proficient in CPT and ICD coding and can identify appropriate utilization of codes. 5. Perform bill review process beginning with data entry and resulting in the approval/denial of services. 6. Utilizes certification to identify services that meet the Miller criteria and makes the decision to override or deny payment. 7. Analyze the billing form in conjunction with the billing codes and C-9 authorizations. 8. Utilize clinical editing software. 9. Discuss billing issues internally with team members and/or with providers, employers and injured workers via oral and written communication. 10. Other duties as assigned. Job Requirements * Education: High school diploma * Skills: Experience using Microsoft Office programs, especially Excel, Word, PowerPoint, and Access. Exceptional written, telephonic, and oral communications, leadership, problem-solving, interpersonal, and organizational skills. Ability to coordinate multiple priorities. * Certification: One of the following: Registered Health Information Administrator (RHIA®), Registered Health Information Technician (RHIT®), Certified Coding Associate (CCA®), Certified Coding Specialist - Physician-based (CCS-P®), Certified Coding Specialist (CCS®), Certified Professional Coder® (CPC®), Certified Professional Coder-Payer (CPC-P®), Certified Inpatient Coder (CIC™), or Certified Outpatient Coder (COC™). Preferred Qualifications * Education: Associate degree preferred and/or minimum (2) - years experience with Ohio BWC billing. * Skills: Knowledge of medical terminology and processes including medical coding ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact Equal Opportunity Employer/Drug-Free Workplace Employee Exemption Type Exempt Job Type Full Time Budgeted Hours / Pay Period 80 Shift Type Days Shift Hours Weekends On-call Requirements Additional Schedule Details Promedica Cleveland OH

Professional Coder II

Cleveland Clinic