Forensic Medical Coder

📋 Description

• • As a Forensic Medical Coder at Ensemble Health Partners, you will play a critical role in ensuring the accuracy and integrity of our clients' revenue cycle management. This position is designed for a certified coding professional with deep expertise in both front-end and back-end coding processes. Your primary responsibility will be to conduct thorough root cause analyses of identified coding opportunities, delving into the intricacies of front-end and back-end coding to pinpoint areas for improvement.
• • You will be instrumental in developing and implementing strategies to address these identified issues, often leading or supporting projects focused on enhancing coding accuracy and efficiency. This involves collaborating with various stakeholders, including physicians, management, and fellow coders, to drive positive change.
• • A key aspect of this role is providing expert coding guidance. You will research and advise on coding practices for new client service lines and services, ensuring compliance and optimal reimbursement. This requires staying current with evolving healthcare regulations, payer guidelines, and coding standards.
• • Maintaining compliance with all established corporate and departmental policies and procedures is paramount. You will uphold quality improvement program standards, customer service expectations, and productivity targets, contributing to the overall success of the revenue cycle.
• • You will be expected to maintain a comprehensive understanding of the workflow and processes within each functional area of coding. This holistic view allows for more effective problem-solving and process optimization.
• • A significant part of your role will involve educating providers and the coding team. You will develop and deliver educational tools and training sessions, communicating complex coding concepts clearly and professionally. This includes participating in coding meetings and calls to share insights and best practices.
• • You will remain continuously abreast of changes to current payer guidelines, Correct Coding Initiative (CCI) edits, and Local/National Coverage Determinations (LCDs/NCDs). This vigilance is crucial for maintaining coding accuracy and compliance.
• • Mentoring team members on coding guidelines and accuracy is a vital function. You will assist in the training of other coders, fostering a culture of continuous learning and skill development within the team.
• • This role encourages initiative and a proactive approach to learning new skills. You will be expected to participate in and share your expertise on projects, committees, and other activities as deemed appropriate by leadership. Demonstrating personal responsibility for your job performance is highly valued.
• • You may be required to travel for education sessions, Continuing Medical Education (CME) events, or other professional development opportunities as determined by Physician Revenue Cycle Leadership.
• • The position requires an understanding of the knowledge and skills necessary to provide care appropriate to the age of the patients served, demonstrating an awareness of growth and development across the life span and the ability to assess and interpret patient status relative to their age and specific needs.
• • You will perform other duties as assigned by your Manager or Supervisor, contributing to the broader goals of the department and the organization.
• • This role is crucial in supporting Ensemble Health Partners' mission to keep communities healthy by keeping hospitals healthy, ensuring that every financial interaction is handled with expertise and care.
• • By empowering you to challenge the status quo, we believe you will be the difference in driving excellence in revenue cycle management.
• • You will contribute to a culture of Customer Obsession, Embracing New Ideas, and Striving for Excellence, aligning with Ensemble's O.N.E Purpose.
• • This position offers the opportunity to work remotely nationwide, providing flexibility and work-life balance.
• • You will be part of an award-winning company recognized for its leadership in revenue cycle management and as a top workplace.
• • Your expertise will directly impact client satisfaction and financial health, contributing to the overall success of Ensemble Health Partners.