Offer summary

Qualifications:

Certified Professional Coder (CPC) or equivalent certification required., Strong knowledge of CPT/ICD-10 coding and billing processes., Experience in auditing and providing feedback on E/M documentation., Familiarity with payer guidelines and compliance regulations..

Key responsabilities:

Review and ensure correct coding for pre-certification based on provider documentation.

Update unbilled charges and resolve clinic coding issues before billing.

Audit physician documentation quarterly and provide necessary training.

Collaborate with teams to support appeals and ensure compliance with coding standards.

UNMATCHED SAFETY.COMPASSIONATE CARE. MISSION Provide demonstrably superior healthcare through a purpose-driven partnership of exceptional people. VISION Be the standard for patient-first healthcare through the intentional delivery of safe, high-quality, compassionate, and personalized care focused on the patient as our top priority each and every day. ABOUT Optim Health System’s large network of highly-skilled physicians, specialty-focused facilities, and experienced nurses and other personnel affords patients, in both larger metropolitan and rural areas of our region, access to the uniquely safe, high-quality, compassionate and personalized care that sets the standard in today’s healthcare marketplace. Our Health System includes the nationally recognized Optim Medical Center-Tattnall, Optim Surgery Center, Optim Medical Center-Screven. Optim Medical Center-Tattnall and Optim Surgery Center are both partially physician-owned in partnership with Surgery Partners. SPECIALTY FOCUSED Optim Heath System also operates over 20 clinics conveniently located across southeastern Georgia which focus on orthopedic injuries and musculoskeletal conditions. While these clinics are owned and managed independent of clinics owned and operated by Optim Orthopedics, Optim Health System’s clinics are aligned as part of the collaborative network the organizations share in serving the communities throughout southeastern Georgia and Beaufort County South Carolina. Optim Health System also includes a collaborative partnership with Spivey Orthopedic Clinics and other notable orthopedic practices across the region. Together this network of highly trained medical staff and board-certified, fellowship-trained physicians offer comprehensive, specialized treatment in multiple areas including orthopedics, neurosurgery, interventional pain management, physical and occupational therapy, and athletic trainers.

Job description

Optim Health System is seeking a full time Professional Fee Coder. This is a remote position.

Primary Duties:

Ø Review order to ensure the correct CPT/ICD -10 codes are utilized for pre cert by reviewing all provider documentation
Ø Responsible for reviewing and updating unbilled hospital charges and clinic coding issues prior to billing the payer
Ø Work with the pre cert team on codes that need to be updated post-surgery, prior to billing
Ø Audit E/M documentation for all physicians quarterly and provide feedback and training
Ø Support RCM Team with appeals and denials related to documentation, coding, authorizations.
Ø Review Payer guidelines for changes in authorization, codes, LCD guidelines, changes in NCCI edits
Ø Provide cheat sheets and documentation training for providers and staff for compliance and maximum reimbursement
Ø Collaborate with Director and the EMR administrator on best practice set up for EHR to simplify orders, documentation and diagnosis selection