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Coder - Scripps Health Plan in San Diego, CA at Scripps Health Plan Services -4S Ranch

Date Posted: 5/10/2019

Job Snapshot

Job Description

At Scripps Health, you will experience the pride, support and respect of an organization that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.


You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.
Be part of the incredible Scripps Organization from our Business Services office in Rancho Bernardo.  This is a small, tightly knit team, where you can contribute your skills and expertise to the overall care of patients by ensuring correct coding is accomplished. 


As a Coder for the Scripps Health Plan you will be responsible for conducting audits and coding reviews to ensure all documentation is accurate utilizing appropriate systems, to include virtual examiner software.  It will be your responsibility to code procedures, diagnoses or conditions, working from the appropriate medical record. Convert diagnosis and procedure data from patient medical record to ICD-9-CM/ICD-10 or similar coding scheme. Complete reimbursement or data abstraction forms for submission to appropriate parties. Identify and sequence the diagnoses and procedures following all medical necessity guidelines. Communicate with Utilization, Provider Relations and vendors about coding errors and disputes.  Anticipates potential problems and is proactive in the effort to prevent them. Perform maintenance of system updates  quarterly and creates and test any necessary customer edits that are required to automate provider contract reimbursement. Meet productivity and quality standards.


This is a Full Time 8 Hour Day position located at the Scripps Business offices in Rancho Bernardo (4S). 


 


Job Requirements

Required Education/Experience/Specialized Skills:
  • Good critical thinking and analytical skills.
  • Excellent written and verbal communication skills.
Required Certification/Registration:
  • Registered Health Information Technician (RHIT), Certified Coding Associate (CCA), or Certified Coding Specialist (CCS) from American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) from American Academy of Professional Coders
Preferred Education/Experience/Specialized Skills/Certification:
  • Associates Degree in Health Information Technology
  • Knowledge of medical terminology, commercial and government health insurance and billing guidelines, ACA requirements, understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPCS Codes and Modifiers.
  • Knowledge of HMO referral and claims process
  • Multispecialty coding experience to include inpatient and outpatient




Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.
 


Scripps Health is repeatedly named on the Fortune Magazine’s 100 Best Companies to work for, only San Diego-based company and Becker’s Healthcare Top Hospitals. Scripps Health offers a robust Total Rewards Program designed to compensate and motivate you throughout your career. Scripps Health Total Rewards Program includes a broad range of plans and programs including market competitive pay and performance incentives, health and wellness benefits, financial wellness benefits, work-life resources, learning and development opportunities, and rewards and recognition. Unlock your potential with Scripps Health today.