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Job Description:

This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, CPT/HCPCS procedure codes, and modifiers to ensure proper reimbursement for complex professional services. Requires extensive knowledge and understanding of ICD-10-CM and CPT/HCPCS coding guidelines, medical terminology, and disease processes. Works closely with clinicians and operations to ensure complete and accurate documentation, coding, and charges for the professional services provided. Adheres to the quality and productivity standards set by the department.

Education Qualifications:

Key Responsibilities:

+ Evaluates health record documentation and charges to ensure proper reimbursement and clinicians’ RVUs by ensuring that ICD-10-CM diagnostic and CPT/HCPCS procedural codes, and modifiers accurately reflect and support the professional encounter

+ Identifies documentation clarification opportunities to ensure that documentation supports the coding and charges for the services provided. Initiates coding queries and provides feedback to clinicians

+ Reviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided

+ Works with the coding denials team for education and assists with denial prevention solutions

+ Ensures professional encounters are coded accurately and in a timely manner

+ Consistently maintains coding quality (95% accuracy) and productivity expectations

+ Assists with the training of professional coders

+ Performs related duties as required

Educational Requirements:

+ Successful completion of a coding program, which included coursework in ICD-10-CM, CPT/HCPCS, medical terminology, anatomy and physiology and disease processes

Required Qualifications:

+ Two (2) years of professional coding experience

Preferred Qualifications:

+ Epic experience

+ 3M Encoder experience

Licensure/Certification Qualifications:

Certification/Licensure Requirements:

+ Current certification with American Health Information Management Association (AHIMA) or AAPC and credentialed as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), and/or Certified Coding Specialist-Physician-Based (CCS-P)

+ Specialty certification, i.e., Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiation Oncology Certified Coder (ROCC), etc. required within two (2) years if coding a specialty that requires a special certification

Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.

**Job Location:** Duluth Family Medicine Clinic

**Shift Rotation:** Day Rotation (United States of America)

**Shift Start/End:** 8:00/4:30

**Hours Per Pay Period:** 80

**Compensation Range:** $22.81 - $34.22 / hour

**FTE:** 1

**Weekends:** NO

It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.