When you join the growing BILH team, you're not just taking a job, you\u2019re making a difference in people\u2019s lives.Under general supervision of the Director of Coding and Validation, the Coding Validator III is responsible for performing quality reviews on medical records to validate the assignment of ICD-10-CM, CPT, HCPC, and modifiers to assure thecorrect APC assignment and other imbursement impacting elements. The Coding Validator III works closely with the Director of Coding and Validation and Coding leadership to assure coding uniformity, consistency and accuracy ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The Coding Validator I is also responsible for coding functions to support timely coding and billing. The Coding Validator II is also responsible for exceeding quality and quantity expectations while performing coding functions to support timely coding and billingJob Description:Essential Duties & Responsibilities: \u2022 Performs pre-bill reimbursement audits on outpatient records to determine if codes need to be added/deleted, to ensure that the care of the patient is recorded in language that the payers can interpret, and coding is compliant with all coding guidelines.\u2022 Provides appropriate educational feedback to coding staff related to coding and reimbursement changes.\u2022 Performs Outpatient only and unlisted CPT/HCPC reviews.\u2022 Performs Claim edit and Denial reviews\u2022 Performs monthly post-bill coding audits\u2022 Performs focused CPT/APC audits\u2022 Performs data and analysis of coding quality data to identified coding error trends.\u2022 Reviews findings of third-party coding audits.\u2022 Prepares appeal letters to third party audit when deemed appropriate.\u2022 Provides appropriate orientation and ongoing in-service training/education for coding staff in coding, documentation, and reimbursement methodologies.\u2022 Serves as a central resource for outpatient coding questions.\u2022 Prepares and presents monthly focused education for the coding department\u2022 Prepares coding resource documents to support coding accuracy and consistency.\u2022 Responsible for coding all types of outpatient medical records with efficiency and accuracy.\u2022 Responsible for writing compliant retro coding queries to providers when indicated.\u2022 Works with programmers to define specifications as well as test systems and applications related to the 3M coding software and Epic.\u2022 Attends meetings and educational conferences, assuming personal responsibility for professional development and ongoing education to maintain proficiency.\u2022 Works on special coding related projects and serves as a coding resource for other BILH departments.Minimum Qualifications:Education:\u2022 High School diploma or equivalent, required\u2022 Minimum of Associate degree in Health Information Management or Completion of a AHIMA or AAPC Coding Certification program, requiredLicensure, Certification & Registration: \u2022 RHIA, RHIT or CCS from AHIMA or a COC from AAPC, requiredExperience: \u2022 Computer skills\u2022 Minimum 5 year of ICD-10-CM, CPT/HCPC Outpatient coding assignment, required\u2022 Minimum 1 year of ICD-10-CM, CPT/HCPC outpatient coding assignment at a Level 1 trauma or Academic Medical Center, preferred\u2022 Minimum of 5 years OP coding auditing and/or OP coding validation, preferred \u2022 Microsoft Office applications\u2022 Interventional Radiology, Cardiac Cath, Injection and Infusion, Observation, and Ambulatory Surgery coding experience, requiredRequired Skills, Knowledge & Abilities: \u2022 Medical terminology \u2022Proficient in Microsoft Office Excel, Word and PowerPoint applications\u2022 Knowledge and understanding of current ICD-10-CM and CPT/HCPC Official Guidelines for Coding and Reporting\u2022 Knowledge of medical records content and management\u2022 Strong written communication skills\u2022 Working knowledge of the EMR either through experience or education, including experience working with structured data and database management\u2022 Knowledge of laws and regulations about health information and patient confidentiality\u2022 Adheres to Department, Hospital, and Human Resource Policies PreferredQualifications & Skills: \u2022 Epic experience\u2022 3M-360 Computer Assisted Coding Dept\u2022 OP Validator III level ICD-10-CM, CPT Outpatient code assignment skills based on BILH OP Coding Validator Exam Pay Range: $31.37 - $50.20The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.Equal Opportunity Employer/Veterans/Disabled