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Role Description

The Senior Professional Coder performs at an advanced level medical coding position and serves as an expert utilizing ICD-10 and CPT4 classification system coding to all diagnoses, treatments, and procedures in all types of Hospital, Clinic, and Ambulatory Surgical Center (ASC) locations at stated minimum performance levels. In addition, the Senior Professional Coder provides coding insight and guidance to clinical staff, Clinical Documentation Improvement (CDI), Professional Coder 1 and Professional Coder II positions as well as Revenue Cycle leadership.

Responsibilities

• Assign and sequence all ICD-10; CPT 4; Healthcare Common Procedure Coding (HCPC) and modifier codes for services rendered accurately and completely.
• Reconcile correct coding edits and discrepancies prior to final coding.
• Maintain coding quality of 95% or higher while meeting established productivity requirements based on encounter type.
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations.
• Identify trends in documentation deficiencies and communicate areas of improvement opportunities to leadership and/or providers.
• Act as a key liaison for the physicians and clinical staff as it relates to coding and compliance.
• Interact with physicians and other professional staff on documentation issues relating to coding data.
• Act as a mentor to Coder I and Coder II staff.
• Provide system and workflow training to newly employed coders.
• Prepare and present education in conjunction with the Revenue Integrity Professional Coding Educator.
• Be the primary contact for the Revenue Cycle team throughout Shriners Hospitals for Children (SHC) system to assist with coding questions.
• Act as backup for Revenue Integrity Professional Coding Lead.
• This is not an all-inclusive list of this job’s responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.

Qualifications

• Minimum 7 years of coding experience in inpatient/outpatient professional surgery.
• Experience with Surgery Coding guidelines, E/M Coding Guidelines, CPT Coding, ICD-10, Modifiers, HCPCS, and CCI edits.
• Pediatric, orthopedic and/or injury coding experience.
• Experience with education and presentations.
• Functional knowledge of Medical Terminology.
• Functional knowledge of professional coding practice standards.
• Functional knowledge of MS Office.
• High School Diploma or GED.
• Current CCS-P (AHIMA) or CPC (AAPC).

Benefits

• All employees are eligible for medical coverage on their first day.
• Eligible for a 403(b) and Roth 403(b) Retirement Saving Plan with matching contributions of up to 6% after one year of service.
• Paid time off, life insurance, short-term and long-term disability for FT or PT status (40+ hours per pay period).
• Flexible Spending Account (FSA) plans and Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected.
• Tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance, and more for FT and PT employees.
• Coverage available to employees and their qualified dependents in accordance with the plans.
• Benefits may vary based on state law.