South Dakota Mitchell Jobs

South Dakota Department of Labor & Regulation Logo
South Dakota Department of Labor & Regulation mobile logo

Job Information

Navigant Consulting Inc Remote Medical Coder- Hospital Outpatient- Navigant- Remote Location in MITCHELL, South Dakota

With a unique blend of large firm resources and an entrepreneurial collaborative culture, Guidehouse is where your purpose, passion, and expertise transform organizations. Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting. We help clients address their toughest challenges with a focus on markets and clients facing transformational change, technology-driven innovation and significant regulatory pressure. Across a range of advisory, consulting, outsourcing, and technology/analytics services, we help clients create scalable, innovative solutions that prepare them for future growth and success. Headquartered in Washington DC, the company has more than 7,000 professionals in more than 50 locations. If you’re passionately motivated to make a difference and deliver exceptional work, we invite you to learn more about your career opportunities at www.guidehouse.com

Interested in working with talented people to help develop innovative solutions to some of society’s most complex and challenging problems? We are Guidehouse, a leading consulting firm serving the public sector and commercial clients with specialized capabilities in strategy, technology, and risk management. You may not yet know our name, but we have a rich history. Guidehouse is a combination of PwC’s former public sector practice and Navigant’s deep expertise in energy, financial services and healthcare.

We offer an exciting, fast-paced environment that fosters intellectual growth and rewards individuals based on impact, not tenure. Our firm is at the forefront of an emerging model solving complex problems that stretch across government and private companies, affording our people the opportunity to be on the cutting edge of the consulting profession. By focusing on markets facing transformational change, technology-driven innovation, and significant regulatory pressure, our employees also develop and deploy world class knowledge and problem solving that leads to breakthrough solutions.

Our healthcare segment is comprised of consultants, former provider administrators, clinicians, and other experts with decades of strategy, operational/clinical consulting, managed care services, digital health, revenue cycle management, and outsourcing experience. Professionals collaborate with hospitals and health systems, physician enterprises, payers, government, and life sciences entities, providing performance improvement and business process management solutions that help them meet quality and financial goals. You will make an immediate impact from day one, working with a team to provide end-to-end solutions. We don’t simply put band-aids on our client’s issues, we are working side-by-side with them. Are up for the challenge?

Business Process Management unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.

The Remote Medical Coder- Hospital Outpatient will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. Needs to have previous coding experience in wound care.

  • Computer Literacy.

  • Good working knowledge of Anatomy and Physiology as well as Medical Terminology.

  • Advanced knowledge of CMS/MAC guidance, Coding Skills, ICD-10-CM and CPT.

  • Ability to analyze Provider documentation and assign codes accurately.

  • Excellent verbal and written Communication Skills.

  • Strong knowledge and application of Government and other payer guidelines as they relate to compliant coding.

  • High level of Accuracy and Productivity. Meets or exceeds standards consistently.

  • Ability to work independently.

  • HIPAA compliant work stations.

  • Strong working knowledge of Protected Health Information.

  • Maintains professional credentials at all times.

  • Organizational Skills.

  • Knowledge of Microsoft Word and Excel.

  • Demonstrates the ability to perform quality coding on ancillary, clinic, wound care, emergency room / E&M and outpatient surgery records.

  • Maintains a working knowledge of ICD-9-CM/ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.

  • Assures that all services documented in the patient’s chart are coded with appropriate ICD-9/ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards.

  • Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility or via eWeb.

  • Ability to maintain average productivity standards as follows: Emergency Room Records with E/M 13 charts per hour, emergency room records without E/M 17 per hour, clinic records 16 charts per hour, ancillary/diagnostic 28 charts per hr, outpatient surgery records 5 per hr. (These productivity standards are Navigant’s general expectations and are subject to change based upon Navigant’s client agreements and/or other factors as determined by management. Notification of expected productivity will be conveyed by Management prior to assignment of a client project).

  • Works the review queue on a daily basis to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary.

  • Charts that require re-bills are corrected and communicated to the facility daily for the rebill process. See re-bill policy in facility guidelines.

  • Coder downtime must be reported immediately to the administrative staff to ensure turn around is met.

  • Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.

  • Provides accurate answers to physician’s/hospitals coding and/or billing questions within 8 hours of request.

  • Responsible for coding or pending every chart placed in their queue within 24 hours.

  • It is the responsibility of the coder to notify administrative staff in the event they cannot meet the 24 hour turn around standard.

  • Quality reports must be reviewed, and necessary corrective action plan should be communicated to the IQC manager within five working days of receipt of the monthly quality report.

  • Coders are responsible for checking the Navigant’s email system at least every two hours during coding session.

  • Coders must maintain their current professional credentials while working for Navigant.

  • Coders are responsible for becoming familiar with Navigant’s coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility.

  • Coders are responsible for maintaining HIPAA compliant work stations (reference HIPAA work station policy).

  • Coders are responsible for maintaining patient privacy at all times (reference company handbook policy compliance section 105).

  • Coders are responsible for signing a confidentiality statement.

  • It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content.

  • Works well with other members of the facilities coding and billing team to ensure maximum efficiency and reimbursement for properly documented services.

  • Communicates problems or coding principle discrepancies to their supervisor immediately.

  • Communication in emails should be professional at all times (reference e-mail policy).

  • Previous wound care coding experience.

  • 3 years coding outpatient hospital specialties.

  • 3-5 years ICD-10 and CPT coding experience.

  • Must be hold one or more of the following credentials: RHIA, RHIT, CCS CPC, COC, CCS-P.

  • Must have minimum three years of coding experience.

  • Abide by all client policies and procedures.

  • Abide by all Navigant’s policies and procedures.

  • Must have experience working in systems such as EPIC, Cerner, Next Gen, Allscripts or other EHR.

  • Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.

  • Strong conceptual, as well as quantitative and qualitative analytical skills

  • Work as a member of a team as well as be a self-motivator with ability to work independently

  • Constantly operates a computer and other office equipment to coordinate work

  • Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data

  • Generally works in an office environment

  • This position requires successful completion of a background check and employment verification.

  • The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

DirectEmployers