Applicants must reside in the United States and be a US citizen or green card holder.

EdiPhy Midwest, a leading provider of services to the healthcare industry, is currently looking for full-time or part-time employee or contractor to serve as an Outpatient Surgery Coding Consultant/Auditor on our team. Applicants need to have 5 years of experience with outpatient facility surgery coding in a hospital setting. Expertise in general and orthopedic surgery are required.

Job Summary:

Consultants conduct in-depth evaluation of outpatient charges, coding and billing accuracy and documentation adequacy for accurate reimbursement and risk adjustment.

Our team members are encouraged to be critical thinkers, proactive, self-directed and detail oriented. Healthcare is a challenging industry that requires the ability to flourish in an ever-changing environment. We value each team member and are committed to each other and to the company’s success. It is a professional environment where we have high expectations regarding conduct and communications.

Skills and Qualifications:

• Knowledge of ICD-10-CM, CPT and HCPCS Level II coding
• Knowledge of Medicare OPPS & MPFS reimbursement methodologies along with through knowledge of Medicare reimbursement and billing guidelines.
• Knowledge of medical necessity of services through the CMS part A and B Local and National Coverage Determinations
• Solid understanding of anatomy and physiology is required.
• Software Platforms used at EdiPhy - Microsoft Office (Word, Excel, PowerPoint, Outlook and Sharepoint), FoxIt, TruBridge encoder / grouper software, and various EHRs. Training is provided.

Experience:

• Hospital based outpatient ICD-10-CM, CPT & HCPCS Level II coding; 5 years
• NUBC revenue codes, mapping structures and experience with UB-or and 1500 claim and payment remittance statements, a plus
• Outpatient CDI knowledge, a plus

Certification and licensure:

• Have one of the following - COSC or CGSC preferred. Other credential considered CPC, COC, CPMA, CCS-P, CDEO, CCDS-O

Work Environment: Because the majority of our work can be provided remotely, consultants are able to work from a home office. When travel is required, we make every effort to limit the number of days away from home to two or three days in a week and provide an opportunity for consultant input into the schedule before finalizing with the client.

Physical Demands: Prolonged periods of sitting at a desk and working on a computer.

Job Types: Full-time, Part-time, Contract

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Application Question(s):

• What is your state of residence?

License/Certification:

• Medical Coding Certification (Required)

Work Location: Remote