JOB SUMMARY

Performs audits on inpatient and outpatient medical records to ensure coding accuracy and compliance with official coding guidelines, based on clinical documentation. Verifies abstracted data elements essential for correct reimbursement processes.

ESSENTIAL DUTIES AND RESPONSIBILITIES

– Consulting: Advises facility leadership and staff on best practices, methods, and tools for accurate medical coding.
– Chart Review and Coding Validation: Analyzes medical records to ensure accurate coding of diagnoses and procedures, following AHIMA’s Ethical Coding Standards. Confirms abstracted data such as discharge status, which affects reimbursement and MS-DRG assignment.
– Inpatient and Outpatient Coding: Assigns accurate ICD-9-CM codes for diagnoses and procedures based on medical record review. Extracts required data elements, including discharge disposition.
– Coding: Applies professional judgment and specialized training to assign ICD-9 and CPT-4 codes to patient records.
– Abstracting: Identifies and records required data elements, including discharge disposition, based on client-specific requirements.
– Coding Quality: Maintains high accuracy and consistency in coding principal and secondary diagnoses (including MCC and CC) and procedures. Ensures correct data abstraction per Statement of Work (SOW).
– Clinical Documentation Improvement (CDI): Detects and reports opportunities to improve documentation and resolve coding issues (e.g., missing documentation, physician queries).
– Professional Development: Keeps current with official coding guidelines and CMS directives. Attends required annual coding seminars and quarterly updates.

KNOWLEDGE, SKILLS, AND ABILITIES

– Ability to maintain 95% coding accuracy while meeting productivity standards.
– Must pass a coding proficiency test.
– Strong knowledge of medical terminology, ICD-9-CM, and CPT-4 codes.
– High attention to detail and ability to work independently.
– Proficient in Microsoft Office.
– Strong interpersonal communication skills.
– Self-motivated with effective time management skills.
– Capable of working remotely with minimal supervision.
– Intermediate understanding of disease processes and pharmacology.
– Familiarity with MS-DRG, APC, OCE, and NCCI reimbursement systems.

Note: Candidates must meet all required vaccinations and health screenings before starting, including COVID-19 and flu vaccines, as legally permitted.

EDUCATION / EXPERIENCE

– Associate degree in a relevant field preferred, or equivalent education and experience.
– Minimum of three years of coding experience, including hospital and consulting work.

CERTIFICATIONS

– AHIMA or AAPC certification required.

PHYSICAL REQUIREMENTS

– May involve bending, twisting, and lifting up to 25 lbs.
– May require driving to off-site locations.
– May involve travel by various means (car, plane, train, etc.).
– Must be able to sit for long periods and use a computer keyboard and mouse effectively.

WORK ENVIRONMENT

– May work across multiple client sites.
– Must be capable of working independently in a remote or hospital setting.

OTHER

– Regular travel may be necessary.

ABOUT CONIFER HEALTH

As part of Tenet and Catholic Health Initiatives, Conifer Health brings over 30 years of healthcare expertise to clients across more than 135 U.S. markets. We support clients in improving financial and clinical outcomes, transitioning to value-based care, and enhancing patient experiences. Join us and be part of a team that’s transforming healthcare, with competitive benefits and career growth opportunities.

COMPENSATION AND BENEFITS

Compensation

– Hourly pay: $30.85 – $46.28, depending on location, experience, and qualifications.
– May be eligible for a sign-on bonus for qualified new hires.
– Time and a half pay for work on Conifer-observed holidays.

Benefits

– Medical, dental, vision, disability, and life insurance.
– Paid time off (minimum 12 days/year, accrued at approximately 1.84 hours per 40 hours worked).
– 401(k) with up to 6% employer match.
– 10 paid holidays annually.
– Health savings accounts and flexible spending accounts.
– Employee assistance and discount programs.
– Optional benefits: pet insurance, legal insurance, accident and critical illness coverage, long-term care, elder and childcare, AD&D, auto and home insurance.
– Colorado employees receive paid leave per the Healthy Families and Workplaces Act.

EQUAL EMPLOYMENT OPPORTUNITY

Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Reasonable accommodations are provided for qualified individuals with disabilities unless it causes undue hardship.