Coder II - Medicare Wellness Visits and Transitional Care Management

Department:

13497 Enterprise Revenue Cycle - Coding Production Operations: Professional Coding Operations Medical and Primary Status:

Full time Benefits Eligible:

Yes Hou rs Per Week:

40 Schedule Details/Additional Information:

Will support:

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Medicare Wellness Visits and Transitional Care Management Production Coding Team

Schedule:

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Monday - Friday 1st shift 40 hours a week.

Certification required:

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Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).

Remote opportunity:

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Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

Pay Range:
$26.55 - $39.85 -
Major Responsibilities:

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Independently perform complex, specialty-specific professional fee coding (CPT/HCPCS and ICD-10-CM) for physician services rendered in both office and hospital settings, ensuring expert application of modifiers and E/M guidelines, or;

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Perform entry-level facility coding for simple outpatient encounters (e.g., diagnostic imaging, labs) and basic inpatient services (e.g., uncomplicated admissions, short stays) using ICD-10-CM and ICD-10-PCS, where applicable

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Ensure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standards

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Identify the need for formal clinical queries for documentation clarification when necessary for professional or facility records

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Maintain high accuracy and productivity standards appropriate to the complexity of the assigned workload

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May provide informal guidance to new coding staff on professional coding nuances

​ Licensure, Registration, and/or Certification Required:

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An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA); Dual certifications, preferred

Education Required:

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High School Diploma or Equivalent required

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Completion of an accredited medical coding or HIM program (or equivalent experience)

Experience Required:

​For Entry-Level Roles (Basic Inpatient/Simple Outpatient)

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Foundational experience in facility coding (via education, externship, or applied work) covering basic outpatient and basic inpatient records.

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Experience with Epic or similar electronic health record systems is a plus

For Proficient Roles (Complex Professional Coding)

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Minimum of 3-5 years of direct professional fee coding experience in a multi-specialty environment is required

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Experience with professional procedural coding (e.g., surgical, interventional procedures) is preferred

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Experience with Epic or similar electronic health record systems is required

Knowledge, Skills & Abilities Required:

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Proficient knowledge of medical terminology, anatomy, and pathophysiology

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Advanced proficiency in CPT/HCPCS and ICD-10-CM/PCS coding systems

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Basic understanding of facility payment methodologies (MS-DRGs) as they apply to simple encounters

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Strong analytical skills, attention to detail, and ability to context-switch between different coding guidelines

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Ability to work independently, manage a varied workload, and meet deadlines in a fast-paced environment

Physical Requirements and Working Conditions:

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​Exposed to normal office environment in a remote work setting

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Job may require occasional travel for training or meetings, therefore, may be exposed to road and weather hazards

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May need to be able to lift up to 40 lbs. occasionally (e.g., equipment)

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Sits the majority of the workday, but also may lift, reach, and bend throughout the day

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Operates all equipment necessary to perform the job

This job description indicates