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Hello, We Are ruralMED!
Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.
The Hospital Outpatient Specialty Coder provides timely and accurate coding of clients’ outpatient medical claims, while supporting rural hospitals and the communities they serve. They are responsible for ensuring maximum reimbursement for services through utilizing knowledge of coding rules and regulations and best practice workflows while using multiple software systems.
How This Role Makes an Impact:
- Support hospitals within the evolving rural landscape to achieve excellence
- Be on a team of dedicated, driven experts, passionate to be the best in rural healthcare through demonstrated coding excellence
- Apply problem-solving and critical thinking skills to develop processes and workflows, further enhancing efficacy and accuracy
- Help hospitals maximize reimbursement while supporting the patients with payor communications and accurate payout
What It’s Like Working at ruralMED:
- Our elite and highly skilled team is driven by delivering top-notch results and supporting each other to reach a new level of excellence while making a positive impact on our clients and rural healthcare.
- Discover flexibility and autonomy with a company that understands the true value and benefits of achieving work-life balance.
- Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool for achieving brilliance.
- Our core values are not only motivational, they are also the standard for how we conduct and take pride in our work.
- It Begins With You: Own it.Pave the Way. Never Settle.Be Thoughtful. Be Transparent. Be Extraordinary.Work Fearlessly. Celebrate the Wins.
- Capitalize Our Strengths. Achieve Excellence.
- Learn more about our team: https://ruralrevcycle.com/join-our-team/
How to Succeed in this Role:
- Excellent analytical, critical thinking, and problem-solving skills
- Ability to take direction and work independently
- Strong communication and collaboration skills
- Possess demonstrated advanced coding abilities
- Knowledge of critical access hospital coding; emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic
- Natural ability to quickly and effectively adjust to changing priorities
- Character Traits: solution-based, self-motivated, positive, genuine, driven, responsible
Title: Hospital Outpatient Specialty Coder
Department: Revenue Cycle Resources
Reports To: Coding Manager
Supervises: NA
Status: Full-Time (Remote)
Position Summary:
The Hospital Outpatient Specialty Coder will be primarily responsible for critical access hospital coding; including emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic. They will ensure the timely and accurate coding of medical claims while maximizing reimbursement for services.
Location: Remote within Nebraska, Kentucky, Missouri, Pennsylvania, New Mexico, Kansas, Tennessee, Maryland, Alabama
Note: A Coding Competency Assessment Test will be provided for qualified applicants prior to their first interview.
Qualifications:
Education and/or Experience:
• High School Diploma or GED – required
• Associate Degree - preferred
• Three to five years in emergency room coding, infusion coding, specialty clinic procedure coding - preferred
• Two years’ experience with formal coding training - considered
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) - required
• Knowledge of medical terminology - required
Licenses/Certifications Required:
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.
General Requirements/Job Duties:
Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Specific job duties will vary based upon client assignment. Employee will also abide by ruralMED’s policies as a condition of employment:
Charge Entry
- Receive and review charge entry data from practice sites
- Identify and investigate incomplete or missing charges
Coding:
- Abstract clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems
- Sequence codes according to established guidelines
- Thorough analysis and interpretation of medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement
Other:
- Maintain current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers
- Maintain proficient knowledge of EHR, as well as any other systems, required for performing required job duties
- Communicate issues to management, including payer, system, or escalated account issues
- Identify medical necessity denial trends and provides suggestions for resolution
- May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution.
- Participation in department meetings, in-service programs, and continuing education programs
- Maintain a professional attitude with patients, visitors, physicians, office staff and hospital personnel
- Assure confidentiality of patient information, maintaining compliance with policies and procedures
- Perform other duties as assigned
Required Knowledge, Skills and Abilities:
- High School Diploma or GED
- Associate Degree – preferred
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
- Three to five years in emergency room coding, infusion coding, specialty clinic procedure coding
- Two years’ experience with formal coding training – considered
- Knowledge of medical terminology
Security/Access:
• Remote work is expected 100% of the time unless otherwise agreed upon
• Will have access to confidential information and must abide by the organization's privacy policies and regulations
Equipment Used:
- General office equipment to include: eFax, computer, telephone, etc.
Essential Work Environment & Physical Requirements:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
