Coder II - Medicare Wellness Visits and Transitional Care Management

Job description

Department: 13497 Enterprise Revenue Cycle - Coding Production Operations: Professional Coding Operations Medical and Primary Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : Medicare Wellness Visits and Transitional Care Management Production Coding Team Schedule : Monday - Friday 1st shift 40 hours a week. Certification required : Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $26.55 - $39.85 Major Responsibilities: Independently perform complex, specialty-specific professional fee coding (CPT/HCPCS and ICD-10-CM) for physician services rendered in both office and hospital settings, ensuring expert application of modifiers and E/M guidelines, or; Perform entry-level facility coding for simple outpatient encounters (e.g., diagnostic imaging, labs) and basic inpatient services (e.g., uncomplicated admissions, short stays) using ICD-10-CM and ICD-10-PCS, where applicable Ensure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standards Identify the need for formal clinical queries for documentation clarification when necessary for professional or facility records Maintain high accuracy and productivity standards appropriate to the complexity of the assigned workload May provide informal guidance to new coding staff on professional coding nuances ​ Licensure, Registration, and/or Certification Required: An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA); Dual certifications, preferred Education Required: High School Diploma or Equivalent required Completion of an accredited medical coding or HIM program (or equivalent experience) Experience Required: ​For Entry-Level Roles (Basic Inpatient/Simple Outpatient) Foundational experience in facility coding (via education, externship, or applied work) covering basic outpatient and basic inpatient records. Experience with Epic or similar electronic health record systems is a plus For Proficient Roles (Complex Professional Coding) Minimum of 3-5 years of direct professional fee coding experience in a multi-specialty environment is required Experience with professional procedural coding (e.g., surgical, interventional procedures) is preferred Experience with Epic or similar electronic health record systems is required Knowledge, Skills & Abilities Required: Proficient knowledge of medical terminology, anatomy, and pathophysiology Advanced proficiency in CPT/HCPCS and ICD-10-CM/PCS coding systems Basic understanding of facility payment methodologies (MS-DRGs) as they apply to simple encounters Strong analytical skills, attention to detail, and ability to context-switch between different coding guidelines Ability to work independently, manage a varied workload, and meet deadlines in a fast-paced environment Physical Requirements and Working Conditions: ​Exposed to normal office environment in a remote work setting Job may require occasional travel for training or meetings, therefore, may be exposed to road and weather hazards May need to be able to lift up to 40 lbs. occasionally (e.g., equipment) Sits the majority of the workday, but also may lift, reach, and bend throughout the day Operates all equipment necessary to perform the job This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. #REMOTE #LI-REMOTE Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.