Full-Time

Trauma Surgery Coding Associate III

Posted on 4/16/2025

R1 RCM

R1 RCM

10,001+ employees

Revenue cycle management solutions for healthcare

Compensation Overview

$18.16 - $31.13/hr

Senior

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • High School Diploma or GED required CCS-P, CPC
  • Five (5) years specialty and/or Trauma surgical coding
  • Must be able to demonstrate proficiency in professional services (95% accuracy)
  • Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (ie:Documentation Guidelines ’95 & ’97)
  • Extensive knowledge of government, and commercial payer guidelines
  • Must be able to use standard office equipment and information systems
  • Ability to interact with other employees through effective communication
  • Ability to prioritize and shift workloads to ensure departmental goals align with revenue cycle goals
Responsibilities
  • Assigns codes for diagnoses, treatments and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers
  • Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner
  • Able to accurately abstract information from the medial records into the abstract system, according to established guidelines
  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines
  • Enters and validates codes, charges and other edits flagged in Athena or EPIC for review
  • Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units)
  • Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity
  • Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns
  • Meet and/or exceeds the established coding productivity standards
  • Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards

R1 RCM provides Revenue Cycle Management (RCM) solutions to healthcare providers, including hospitals and physician groups. The company uses technology to streamline financial and administrative processes, helping clients manage patient service revenue more effectively. R1 RCM differentiates itself by focusing on reducing administrative burdens, allowing healthcare providers to prioritize patient care. The goal is to enhance patient experiences and improve financial performance for healthcare organizations.

Company Size

10,001+

Company Stage

IPO

Headquarters

Murray, Utah

Founded

2003

Simplify Jobs

Simplify's Take

What believers are saying

  • R1 RCM's R37 AI Lab aims to transform healthcare financial performance.
  • The shift to value-based care models creates opportunities for RCM solutions.
  • Increased telehealth adoption drives demand for efficient RCM solutions.

What critics are saying

  • Inconsistencies in turnaround times may affect client satisfaction.
  • The acquisition may lead to strategic shifts impacting client relationships.
  • Integration of Palantir's AI tools may face alignment challenges with existing systems.

What makes R1 RCM unique

  • R1 RCM specializes in end-to-end Revenue Cycle Management for healthcare providers.
  • The company integrates AI to enhance accuracy and efficiency in RCM processes.
  • R1 RCM offers performance-based contracts, aligning incentives with client financial outcomes.

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Benefits

Performance Bonus

Professional Development Budget

Growth & Insights and Company News

Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
R1 RCM
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That's why R1 RCM Inc. launched R1 Provider Edge, an education and insights program designed to support its clients' financial success and the professional growth of their revenue cycle employees.

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With patients directly responsible for more and more of their medical costs, R1 is thrilled to introduce R1 Early Out to help healthcare providers reshape and improve patient financial engagement.

Hit Consultant
Mar 21st, 2025
How To Balance Ai And Human Expertise In The Middle Revenue Cycle

Jennifer Weinberg, MD, Physician Advisor and Vice President of Operations, R1While artificial intelligence (AI) can automate many functions within the middle revenue cycle, there remains a need for human expertise to manage complex, nuanced decisions to ensure high accuracy and proper context. Ultimately, AI should complement – not replace – humans to drive greater efficiency without compromising quality. In revenue cycle management (RCM), the middle cycle refers to the phase between the front end, which is patient access and care delivery, and the back end, which encompasses billing and reimbursement. During the middle revenue cycle, the focus is generally on capturing patient data, documenting clinical procedures and treatments, and ensuring compliance with regulatory standards. The greatest challenge associated with middle RCM is often translating the language of a clinical encounter into the vocabulary of the revenue cycle. When it goes wrong, the result may be reimbursement delays, claim denials, and an unsatisfactory patient experience. However, by combining what humans and AI do best, providers can optimize management of the middle revenue cycle. Humans and AI: Combining strengthsIn the medical field, humans excel at solving problems that require nuanced, complex judgment and interpretation, often informed by prior experiences. In contrast, AI performs well in executing consistent, repeatable, routine tasks that often involve combing through massive amounts of data to identify outliers

Business Wire
Mar 14th, 2025
R1 Launches 'R37': An AI Lab to Transform Healthcare Financial Performance in Exclusive Partnership with Palantir

By integrating Palantir's AI tools and capabilities with R1's existing technology and domain expertise, R37 can unlock faster, more precise scalable reimbursement outcomes.

ETF Daily News
Dec 16th, 2024
EP Wealth Advisors LLC Makes New $168,000 Investment in R1 RCM Inc. (NASDAQ:RCM)

EP Wealth Advisors LLC makes new $168,000 investment in R1 RCM Inc. (NASDAQ:RCM).

INACTIVE