Join Cleveland Clinic’s Ob/Gyn & Women’s Health Institute and become a part of one of the most respected healthcare organizations in the world. Cleveland Clinic earned the No. 1 hospital ranking in Ohio, the No. 4 hospital ranking in the country, and was ranked No. 4 in Gynecology in the nation, according to the U.S. News & World Report’s “2022-23 Best Hospitals.” The Ob/Gyn & Women’s Health Institute is committed to providing world-class care for women of all ages and offers women's health services, obstetrics and gynecology throughout Northeast Ohio and beyond.

We are looking for a Professional Coder III to join our team of devoted caregivers where you will monitor, review, and apply correct coding principles to clinical information received from ambulatory areas for the purpose of reimbursement, research and compliance. As a Professional Coder III, your primary duties include, but are not limited to:

• Identifying and applying diagnosis codes, cot codes, and modifiers as appropriately supported by the medical record in accordance with federal guidelines.
• Ensuring that billing discrepancies are held and corrected.
• Coding a variety of different specialties within the Ob/Gyn & Women’s Health Institute.

The ideal future caregiver is someone who:

• Has surgical coding experience.
• Has strong critical thinking, communication and analytical skills.
• Is technologically proficient.
• Demonstrates a strong work ethic.

This is an excellent opportunity for someone who seeks to enhance their coding skills while working remotely.

At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.

Responsibilities:

• Compares and reconciles daily patient schedules/census/registration to billing and medical records documentation for accurate charge submission, which includes (but not limited to) processing of professional charges, facility charges, manual data entry.
• Maintains records to be used for reconciliation and charge follow up.
• Investigates and resolves charge errors.
• Meets coding deadlines to expedite the billing process and to facilitate data availability for CCF providers to ensure appropriate continuity of care.
• Responsible for working professional held claims in CCF claims processing system.
• Reviews, abstracts and processes services from surgical operative report.
• Reviews, communicates and processes physician attestation forms.
• Communicates with physician and other CCF departments (co-surgery) to resolve documentation discrepancies.
• Assists with Evaluation and Management (E&M) audits and other reimbursement reviews.
• Responsible for working E&M denials on the denial database.
• Other duties as assigned.

Education:

• High School Diploma / GED or equivalent required.
• Specific training related to CPT procedural coding and ICD9 CM diagnostic coding through continuing education programs/ seminars and/or community college.
• Working knowledge of human anatomy and physiology, disease processes and demonstrated knowledge of medical terminology.

Certifications:

• Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS-P), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA) or Certified Outpatient Coder (COC) by American Academy of Professional Coders is required and must be maintained.

Complexity of Work:

• Coding assessment relevant to the work may be required.
• Requires critical thinking and analytical skills, decisive judgment and work with minimal supervision.
• Requires excellent communication skills to be able to converse with the clinical staff.
• Applicant must be able to work under pressure to meet imposed deadlines and take appropriate actions.

Work Experience:

• Minimum of 3 years coding to include 1 year of complex coding experience in a health care environment and or medical office setting required.
• Must demonstrate and maintain accuracy and proficiency in coding and claims editing to be considered for a Professional Coder III position.
• Internal candidate must currently be employed as a Professional Coder II at the Cleveland Clinic or have met all the training, quality and productivity benchmarks of a Professional Coder II.

Physical Requirements:

• Typical physical demands involve prolonged sitting and/or traveling through various locations in the hospital and dexterity to accurately operate a data entry/PC keyboard.
• Manual dexterity required to locate and lift medical charts.
• Ability to work under stress and to meet imposed deadlines.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required for procedures.