Full Job Description

R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals, and physician practices. Headquartered in Chicago, R1® is a publicly traded organization with employees throughout the US and international locations.

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Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients, and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.

The Coding Assoc III will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance).

Under the direction of the Coding Leadership Team, the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.

Schedule is primarily Monday - Friday in EST 8am - 4pm

Responsibilities:

• Assigns codes for diagnoses, treatments, and procedures according to the
• appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
• Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.
• Able to accurately abstract information from the medial records into the abstract system, according to established guidelines
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines
• Enters and validates codes, charges and other edits flagged in Athena or EPIC for review
• Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (i.e.: NDC #, or number of units)
• Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity
• Communication with other departments, including offshore team, to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns
• Meet and/or exceeds the established coding productivity standards

Required Qualifications:

• High School Diploma or GED required
• CCS-P, CPC
• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (i.e.: Documentation Guidelines ’95 & ’97)
• Basic knowledge of government, and commercial payer guidelines.
• Must be able to use standard office equipment and Microsoft Office.
• Ability to interact with other employees through effective communication.
• Ability to prioritize and shift workloads to ensure departmental goals align with revenue cycle goals
• Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards

Preferred Qualifications

• 3 years professional coding experience
• Working in OBGYN, surgical or radiology
• Experience running reports

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company provides a workplace free from harassment based on any of the foregoing protected categories.

For this US-based position, the base pay range is $18.16 - $31.13 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.