When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

　　Job Type:

　　Regular

　　Scheduled Hours:

　　40

　　Work Shift:

　　Day (United States of America)

　　With oversight from the department Manager and exercising independent judgment within the scope of their professional practice, the Certified Professional Coder performs a variety of tasks associated with coding physician and other provider charges, and providing coding education to providers in that area. Duties include hands-on coding, documentation review, coding dictionary updates, rejections and denials, surgical coding, physician or other care provider education, and other coding needs for ICD-9, ICD-10 and CPT coding of inpatient and outpatient professional charges.

　　Job Description:

　　Essential Duties & Responsibilities including but not limited to:

　　1. Coding Responsibilities:

　　Provides review and/or coding of any professional services including but not limited to surgeries, encounters, and diagnostic services for appropriate use of CPT, ICD-9, ICD-10, HCPCS, and Modifier usage/linkage as well as provide ICD-9 coding where needed for handwritten/missing diagnoses.

　　Provides same for areas where workfiles are used. In areas where paper is used, reconcile daily charges against log (if available/applicable) to ensure daily capture of coding charges expected. Productivity and accuracy for workfile and non-workfile standards must be met according to guidelines set by manager.

　　Review and assist in updates of coding dictionaries/encounter forms/charge slips as needed for accuracy of CPT, HCPCS and ICD-9 & ICD-10 Coding.

　　Periodic review of codes, at least annually or as introduced or require for new, revised, or deleted code updates.

　　Answers and responds accurately and timely to questions on the telephone, voice mail, e-mail, Coding Hotline and/or Coding Website as appropriate.

　　Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding corrections via paper or electronic submission to the PFS Department.

　　Reports regularly on daily activity, productivity, and findings of reviews/rejections/education via electronic file or database, e-mail, paper, or other means as required by manager.

　　2. Physician/Provider Education:

　　Confers regularly with physicians/care providers, clinical or ancillary managers, coders, or other staff through departmental staff meetings, one-on-one meetings, and/or daily interactive communication to respond to and educate providers on specific departmental and clinic wide coding issues and updates including but not limited to the coding hotline and/or the coding website.

　　Participates in new physician/care provider orientation as well as provide follow-up reviews and education for the new physician/care provider if applicable for the area of responsibility.

　　Provides feedback, recommendations, and participates as the coding representative for the Professional Coding Department on the Revenue Cycle Teams as requested by manager.

　　Develops and conducts a schedule of physician/care provider documentation reviews in areas where applicable and/or as defined by manager.

　　Provides feedback to the physician/care provider, Department Chair, and/or Administration as required.

　　Documentation review is ongoing and feedback will be provided to the physician/care provider, Department Chair, and/or Administration as required.

　　3. Education & Professional Development:

　　Researches and stays updated and current on CMS (HCFA), AMA and Local Coverage Determinations (LCD’s), or Local Medical Review Policies (LMRP's) to ensure compliance with coding guidelines.

　　Communicates new guidelines to providers through physician/care provider and/or departmental meetings.

　　Stays current on quarterly CCI Edits, bi-monthly Medicare Bulletins, Medicare's yearly fee schedule, Medicare Website, and specialty newsletters.

　　Makes guidelines available via, paper, on-line access, web access, or any other means provided by manager.

　　4. Organizational Requirements:

　　Maintains strict compliance with BILH Confidentiality Policy

　　Incorporates ​BILH Guiding Principles,​Mission Statement and Goals into daily activities.

　　Complies with all BILH Policies.

　　Complies with behavioral expectations of the department and BILH.

　　Maintains courteous and effective interactions with colleagues and patients.

　　Demonstrates an understanding of the job description, performance expectations, and competency assessment.

　　Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.

　　Participates in departmental and/or interdepartmental quality improvement activities.

　　Participates in and successfully completes Mandatory Education.

　　Maintains minimum certification requirements for coding.

　　Performs all other duties as needed or directed to meet the needs of the department.

　　Minimum Qualifications:

　　​Education: High School Diploma or equivalent, plus additional specialized training associated with attainment of a recognized Coding Certificate.

　　​​Licensure, Certification, Registration: CPC (Certified Professional Coder through American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information Management Association) or CPC-A .

　　Skills, Knowledge & Abilities: more detailed as before

　　Demonstrates a thorough understanding of the body of knowledge required for attainment of a college-level coding certificate as indicated above.

　　Computer skills, including word processing, spreadsheets, data entry, research, reporting, and accessing multiple hospital-wide systems.

　　Excellent oral and written communication skills.

　　Demonstrates proficiency as a teacher and/or educational resource to others in sharing knowledge and providing direction within the scope of the job.

　　In the absence of certain of these skills, demonstrates the ability to be thoroughly trained to meet organizational requirements.

　　​​

　　​Experience: Minimum 2 years Professional Coding experience in conjunction with requirements indicated above; or 4+ years coding or related experience in a private practice.

　　FLSA Status:

　　Non-Exempt

　　As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

　　More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

　　Equal Opportunity Employer/Veterans/Disabled