Job Description
Are you an expert in medical classification and compliance?
Pioneer Health Systems is seeking a highly skilled Senior Medical Coder to join our dynamic team in Boston. In this pivotal role, you will ensure the integrity of our healthcare data, optimize revenue cycles, and maintain strict adherence to regulatory standards.
As a Senior Coder, you will bridge the gap between clinical documentation and financial accuracy, working closely with physicians and auditors to ensure every patient encounter is captured with precision.
Responsibilities
- Assign and Audit Codes: Accurately assign ICD-10-CM and CPT-4 codes to medical records while conducting regular audits to identify and correct errors.
- Compliance Management: Ensure all coding practices comply with HIPAA, CMS guidelines, and internal organizational policies.
- Clinical Collaboration: Consult with physicians and healthcare providers to clarify diagnoses and resolve documentation queries to support proper coding.
- Process Improvement: Identify trends in coding errors and recommend process improvements to enhance revenue cycle efficiency.
- Team Mentorship: Mentor junior coders, providing guidance on complex coding scenarios and best practices.
- Regulatory Updates: Stay current with changes in medical coding guidelines and regulatory requirements.
Qualifications
- Certification: RHIA, RHIT, CCS, or CPC certification required.
- Experience: Minimum of 3-5 years of progressive experience in acute care or ambulatory coding.
- EMR Proficiency: Strong working knowledge of Epic or Cerner electronic health record systems.
- Attention to Detail: Exceptional ability to review complex medical documentation with high accuracy.
- Regulatory Knowledge: Deep understanding of ICD-10 coding conventions and CPT guidelines.
- Education: Bachelor’s degree in Health Information Management, Healthcare Administration, or related field preferred.