Surgical Case Reviewer: Certified Coder (F/T) - Remote

Remote: 
Full Remote
Contract: 
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Offer summary

Qualifications:

Certified Professional Coder with three or more years of experience in relevant fields., Strong knowledge of coding guidelines and payer requirements., Experience with electronic health records is essential., Ability to communicate effectively with medical professionals..

Key responsibilities:

  • Review surgical orders for accuracy and appropriate documentation.
  • Provide feedback to physicians on discrepancies in coding.
  • Conduct Medical Necessity reviews according to payer guidelines.
  • Collaborate with multi-disciplinary teams to ensure coding accuracy.

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Optim Health System https://optimhealthsystem.com/
1001 - 5000 Employees
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Job description

Optim Health System is seeking (2) full time Surgical Case Reviewer: Certified Coder(s). This is a remote position.

JOB TITLE: Surgical Case Reviewer: Certified Coder

SUPERVISION RECEIVED: Reports directly to Patient Access Director

SUPERVISION EXERCISED: None

TYPICAL WORKING CONDITIONS: Remote

ESSENTIAL DUTIES AND RESPONSIBILITIES: (This list may not include all of the duties assigned.)

· Review all surgical orders submitted for All Optim facilities

o Focusing on Orthopedic, Neuro Spine, Ortho Spine, Sports Medicine, Pain Management

· Orders reviewed for appropriate documentation and coding; feedback given to physicians on any discrepancies

· Medical Necessity reviews according to payer guidelines

· Communication and education with Surgeons and Surgical teams

· Works with Multi-disciplinary teams to ensure codes on order and precertification are accurate and complete

· Ability to stay current on all relevant coding guidelines as well as payer requirements

· Meets or exceeds industry standard production levels and maintains 95% accuracy in quality assurance reviews

· Experience with electronic health records

· Assisting Clinical Revenue with Medical Necessity denials

CERTIFICATE/LICENSE: Certified Professional Coder with three or more years of experience in focus fields listed above.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Detail Oriented
  • Teamwork
  • Communication

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