Guidehouse is a leading management consulting firm serving the
public and commercial markets. We guide our clients forward towards
new futures that build trust in society and your professional
skills along the journey. Join us at Guidehouse.
The Pro Fee Medical Coder- E&M must be proficient in E/M
coding for all places of services. 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. The coder
scope may involve reviewing coding related denials from payers and
recommending the appropriate action to resolve the claim based on
Demonstrates the ability to perform quality coding on ancillary
charts, clinic charts, and emergency room records.
Maintains a working knowledge of 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-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.
Ability to maintain average productivity standards as
Works the review queue daily 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 re-bill process. See re-bill policy in
Coder downtime must be reported immediately to the
administrative staff to ensure turnaround 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 eight 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 twenty-four hour turn
Coders are responsible for checking the Guidehouse email system
at least every two hours during coding session.
Coders must maintain their current professional credentials
while working for Guidehouse.
Coders are responsible for becoming familiar with the Guidehouse
coding website and using the information contained in the website
as a daily tool to correctly code and abstract for each
Coders are responsible for maintaining HIPAA compliant
workstations (reference HIPAA workstation policy)
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 insure maximum efficiency and reimbursement for
properly documented services.
Communicates problems or coding principle discrepancies to their
Communication in emails should always be professional (reference
+ Must be hold one of the following credentials: CPC, COC,
+ 3 years multi-specialty E/M coding experience.
+ Familiarity with 2021 E/M Guidelines
+ Must maintain credential thoughout employment
+ Must be able to work independently,multi task well and
interface with all levels of personnel as well as clients
+ Abide by all client policies and procedures.
+ Abide by all Guidehouse policies and procedures.
+ Must have experience working in systems such as EPIC, Cerner,
Next Gen, Allscripts or other EHR.
+ Excellent verbal, written adn interpersonal communication
+ Advanced knowledge of Excel, Word and Powerpoint
+ Strong working knowledge and experience with federal and state
coding regulations and guidelines
+ Personal responsibility, respect for self and others,
innovation through teamwork, dedication to caring and excellence in
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.
Candidates from Eastern Standard Time, Central Standard Time,
and Pacific Standard Time Zones as well as candidates from Arizona,
New Mexico and Utah will be considered for this position.
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
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.
Rewards and Benefits
Guidehouse offers a comprehensive, total rewards package that
includes competitive compensation and a flexible benefits package
that reflects our commitment to creating a diverse and supportive
+ Medical, Rx, Dental & Vision Insurance
+ Personal and Family Sick Time & Company Paid Holidays
+ Parental Leave and Adoption Assistance
+ 401(k) Retirement Plan
+ Basic Life & Voluntary Life Insurance
+ Health Savings Account, Dental/Vision & Dependent Care
Flexible Spending Accounts
+ Short-Term & Long-Term Disability
+ Tuition Reimbursement, Personal Development & Learning
+ Skills Development & Certifications
+ Employee Referral Program
+ Corporate Sponsored Events & Community Outreach
+ Position may be eligible for a discretionary variable