Senior Medical Coder- ED Facility & Professional

Emergency Services (ED) Single Pass Facility & Professional Medical Coder:

Position Summary:

The ED Single Pass Medical Coder is responsible for concurrent coding of facility and professional services using Epic’s Single Pass workflow. This role ensures accurate, compliant service-level reporting by leveraging Epic’s Facility Charge Calculator and integrated coding tools. The coder reviews, analyses, and assigns codes for ED encounters to support reimbursement, regulatory compliance, and documentation integrity.

Work Location: Multiple on-site

Key Responsibilities:

Epic Single Pass Coding Workflow:

• Code facility and professional services concurrently using Epic’s Single Pass interface.
• Assign CPT, HCPCS, and ICD-10-CM codes based on encounter documentation.
• Validate charge capture using Epic’s Facility Charge Calculator.

Manual Coding for Complex Services:

• Manually code infusions, injections, and procedures when automation is insufficient.
• Review operative reports, infusion flowsheets, and nursing documentation for time-based and procedural accuracy.

Compliance & Audit Readiness:

• Ensure coding accuracy per CMS, NCCI, AHA, and AMA guidelines.
• Collaborate with CDI and audit teams to resolve documentation gaps and support credentialing.

Encounter Review & Data Validation:

• Assign ICD-10-CM diagnoses and CPT/HCPCS procedures, including E/M levels and modifiers.
• Abstract and validate diagnoses, procedures, and charges.
• Query providers to clarify incomplete or ambiguous documentation.
• Identify deficiencies impacting medical necessity.

Performance & Quality:

• Maintain current knowledge of coding guidelines and regulatory updates.
• Participate in audits, training, and quality improvement initiatives.
• Meet defined productivity and accuracy benchmarks.
• Ensure HIPAA compliance and data security.

Qualifications:

• Education:

  Bachelor’s or Master’s degree in Life Sciences.

• Certification:

  Active AAPC or AHIMA credential (e.g., CPC, CCS, CCS-P).

• Experience:

  Minimum 4 years in facility and professional coding.

• Communication:

  Strong documentation review and communication skills.

Technical Skills:

• Proficient in Epic (EpicCare, Facility Charge Calculator, Single Pass workflows) or other EMRs (Cerner, Meditech, etc.).
• Experience with Solventum (3M), Microsoft Nuance, Optum, etc.
• Expertise in E/M leveling, charge capture, and facility billing.
• Advanced knowledge of ICD-10-CM, CPT, and HCPCS.

Preferred Skills:

• Advanced proficiency in Epic Single Pass and infusion coding logic.
• Strong understanding of modifier usage and outpatient procedural coding.
• Skilled in reviewing documentation for medical necessity.