Shift Days: Monday- Friday, Shift Hours : Varies
R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1® is a publicly-traded organization with employees throughout the US and international locations.
Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
The Physician Coder – Level 3 may work directly with providers, clinical leaders and other healthcare administrators across a defined geographic region to ensure excellent delivery of R1’s coding management services. This position may be responsible for answering questions pertaining to coding from providers and clinical leaders in their region, evaluating and addressing both clinical and financial concerns using their coding knowledge, and more. Additional responsibilities include: reviewing clinical documentation and diagnostic results to evaluate correct coding assignment, directly assigning appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, reviewing and correcting coding-related claim denials, and providing reporting pertaining to operational and quality statistics.
The successful candidate must have demonstrated proficiency in professional service coding and be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. The candidate will adhere to the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) at all times.
- Answering questions pertaining to coding from providers and clinical leaders in your geographic region.
- Evaluating and addressing both clinical and financial concerns arising from your geographic region.
- Providing guidance on billing/coding discrepancies, questions and issues to providers and customers.
- Creating action plans for any identified issues and managing cross-functional teams to drive those action plans to completion.
- Identifying operational barriers and constraints and using problem solving skills to structurally resolve the issues moving forward.
- Reviewing physician assigned diagnosis code and launch queries to providers for additional clarity in a professional manner.
- Assigning codes for diagnoses, E/M, treatments and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers- MUST HAVE MULTI SPECIALTY CODING EXPERIENCE - 3 yrs
- Reviewing documentation to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units)
- Using CCI edits to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity.
- Onboarding and training new global team members.
- Must have a flexible schedule.
- Additional duties as assigned by management.
- Active CCS-P, COC, CPC certifications
- Minimum of 3 years professional coding experience
- Minimum of 3 years Multi Specialty Coding and Vascular Coding
- Extensive knowledge of official coding conventions and rules established by the American Medical Association (“AMA”) (i.e. Documentation Guidelines ’95 & ’97)
- Extensive knowledge of government, and commercial payer guidelines.
- Must be able to use standard office equipment and information systems.
- Basic (or higher) skill level using Microsoft Office products (e.g. Excel, Word, Powerpoint)
- Strong problem-solving skills
- Ability to interact with other associates and leaders through effective communication.
- Ability to prioritize and shift workloads to ensure departmental goals align with revenue cycle goals
Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.
Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit:R1RCM.com.
R1 RCM Inc. (“the Company”) is committed to the principles of equal employment opportunity. The Company’s practices and employment decisions, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is committed to providing a workplace free from harassment based on any of the foregoing protected categories.