Coding Compliance Specialist jobs in Cedar Falls, IA

Coding Specialist II reviews inpatient and outpatient medical records for documentation, abstracting and

analyzing. Assign all codes to the highest level of specificity following the current guidelines for ICD-10-CM, CPT, and

HCPCS. Understand and properly apply modifiers, CCI edits, medical policy rules (e.g., LCD/NCD), etc., in compliance

with payor regulations.

Location: This position is open to remote/work from home with strong preference for candidates residing within the UPH geographies of Iowa, Illinois, & Wisconsin.

What are team member vaccine requirements?

As part of keeping our communities safe and healthy, all team members must be vaccinated for influenza and Tdap, provide proof of immunity to MMR and varicella, and be tested for tuberculosis. New hires must submit proof of vaccination or an approved exemption to begin work. If you have questions, please contact a recruiter or ask at any time during the interview process. UPH strongly recommends that all team members receive the updated 2023-2024 COVID-19 vaccine, and at this time, UnityPoint Health – Meriter requires Covid-19 vaccination or an approved exemption.

Why UnityPoint Health?

• Commitment to our Team – We’ve been named a  Top 150 Place to Work in Healthcare 2022  by Becker’s Healthcare for our commitment to our team members.
• Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience  a culture  guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
• Benefits – Our competitive  Total Rewards  program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.
• Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
• Development – We believe equipping you with support and  development opportunities  is an essential part of delivering a remarkable employment experience.
• Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.

Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work.  https://dayinthelife.unitypoint.org/ 

Coding and Department Support

• Assigns procedural codes according to coding conventions defined by the American Medical Association’s CPT manual, CMS, including the Correct Coding Initiative, Medicaid and other third-party payor policies as applicable.
• Assigns diagnosis codes according to the ICD-9 and/or ICD-10 Official Guidelines for Coding an Reporting.
• Working knowledge of modifiers, CCI edits, HCPCs, LCD/NCDs and other applicable tools to insure compliance with payer regulations.
• Research and resolve coding related issues accordingly per established EPIC Charge Review Work Queue functionality.
• Collaborate with Clinical Auditors to identify opportunities for improvement and provide guidance/counsel to providers.
• Monitor environmental conditions in order to secure protected health information.
• Maintain departmental and organizational awareness by attending meetings as required, reading emails and regularly checking information on the organization’s intranet site.
• Maintain regular and consistent attendance at work.
• Maintain compliance with Personnel policies and procedures.
• Balance team and individual responsibilities; be open and objective to other’s views; give and welcome feedback; contribute to positive team goals; and put the success of the team above own interests.
• Perform other duties as requested to facilitate the smooth and effective operations of the organization.
• Consistently research and resolve coding related denials per payer regulations.
• Charge entry of CPT and ICD-9/ICD-10 codes
• Collection and/or analysis of coding-related data for training purposes or presentation as needed.
• Behave in a manner consistent with all Compliance and HIPAA policies and procedures.
• Demonstrate initiative to improve quality and customer service by striving to exceed customer expectations.

Education: Highschool Diploma/GED

Experience: Three (3) years professional coding experience.

License(s)/Certification(s): Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC) certification status required.

Knowledge/Skills/Abilities:

• Ability to handle complex procedural coding (i.e., invasive & image guided procedures, complex surgical cases) in both inpatient and outpatient settings.
• Expertise in Evaluation and Management coding in both inpatient and outpatient settings.
• Experience training/mentoring new coders or staff. Knowledge of ICD-9/ICD-10 diagnosis, Current Procedural Terminology (CPT) and HCPCS codes.
• Advanced knowledge and/or training related to Risk Adjustment coding and Hierarchical Condition Categories.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Extensive knowledge of regional business lines and related workflows.
• Ability to understand government and non-governmental policies and procedures and apply guidelines.
• Knowledge of medical billing and third-party reimbursement policies.
• Strong interpersonal and communication skills.
• Ability to work as a team member.
• Strong computer skills.
• Strong verbal and written communication skills.