Professional Fee Coder II And III

Cleveland Clinic Cleveland , OH 44114

Posted 2 months ago

Job Summary:

This position is posted as a JIC (Job Interest Community). You are submitting your application for Professional Fee Coder II and III opportunities. Once you apply, we will personally review your application to ensure that you meet the minimum qualifications and have completed the entire application. At that time, you may be contacted to discuss your experience. This way, we can be sure that the job you apply for is the perfect fit for you.

Please be advised that these positions are NOT 100% remote, candidates must reside in the Cleveland OH area to be considered*

Professional Fee Coder II

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.

  • 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.

Education:

  • High school diploma or equivalent.

  • 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).

  • Existing CCF employees credentialed with CMC may be required to obtain CPC (or CCS-P, RHIT, or CCA) within 12 months.

Complexity of Work:

  • 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 two 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.

Professional Fee Coder III

Responsibilities:

  • Compares and reconciles daily patient schedules/census/registration to billing and medical records documentation for accurate charge submission, which includes (but not limited to) processing of professional charges, facility charges, manual data entry.

  • Maintains records to be used for reconciliation and charge follow up.

  • 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.

  • Responsible for working professional held claims in CCF claims processing system.

  • Reviews, abstracts and processes services from surgical operative report.

  • Reviews, communicates and processes physician attestation forms.

  • Communicates with physician and other CCF departments (co-surgery) to resolve documentation discrepancies.

  • Assists with Evaluation and Management (E&M) audits and other reimbursement reviews.

  • Responsible for working E&M denials on the denial database.

  • Other duties as assigned.

Education:

  • High School Diploma / GED or equivalent required.

  • Associate's degree preferred.

  • Specific training related to CPT procedural coding and ICD-10 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), Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA).

Complexity of Work:

  • Requires critical thinking and analytical skills, decisive judgment and work with minimal supervision.

  • Requires excellent communication skills to be able to converse with the clinical staff.

  • Applicant must be able to work under pressure to meet imposed deadlines and take appropriate actions.

Work Experience:

  • Minimum of 3 years coding to include 1 year of complex coding experience in a health care environment and or medical office setting required.

  • Must demonstrate and maintain accuracy and proficiency in coding and claims editing to be considered for a Professional Coder III position.

  • Candidate must currently be employed as a Professional Coder II at the Cleveland Clinic or have met all the training, quality and productivity benchmarks of a Professional Coder II.

#LI-LF1

The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees 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. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. 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 facility.

Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities


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