Coder 2 (Remote) ID-12095

Responsibilities Job Description

Job Summary:

 

 Coders analyze clinical documentation; assign appropriate diagnosis, procedure, and, in some cases, levels of service codes; and abstract the codes and other clinical data. Performs a variety of technical functions within the Hospital Outpatient coding area, codes ancillary outpatient visits, home health, hospice, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM and CPT-4 Coding Classification systems. Utilizes an encoder and computer assisted coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record abstract for a variety of like outpatient visit types like those listed above. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. OP Coding also resolve clinical documentation and charge capture discrepancies and provide feedback to providers on the quality of their documentation and charging.

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Job Expectations:

  •  Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards.
  •  Actively participates in creating and implementing improvements.
  •  Assigns ICD-10 or CPT codes to all diagnoses, treatments, and procedures, according to official coding guidelines.
  •  Validates computer assisted coding (CAC) generated and suggested codes in conjunction with encoder.
  •  Extracts required information from electronic medical record and enters encoder and abstracting system.
  •  Follows-up on unabstracted accounts to assure timely billing and reimbursement.
  •  Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. May query physicians on documentation according to established procedures and guidelines.
  •  Meets productivity and quality standards as specified by manager.
  •  Review OASIS documentation for accuracy.
  •  Provide on-going learning to staff regarding coding practices.
  •  Complete projects as assigned.
  •  Share payer specific guidelines to ensure correct coding.
  •  Performs other responsibilities as needed/assigned.


Qualifications

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Minimum Qualifications to Fulfill Job Responsibilities:

 

Credentials: Knowledge of medical terminology, anatomy, physiology, disease process, ICD-10-CM, CPT, APCs, and/or other coding systems. Knowledge of encoders and coding guidelines. Knowledge of clinical classification systems, and reimbursement methodologies with the ability to identify, review, and interpret and assign correct ICD-10 codes.

 

Education

  •  Certificate program in  coding or associate degree in HIM or a certificate with 1-3 years of healthcare experience (MA, HUC, Revenue Cycle)

 

 

Preferred

 

Education

  •  Associate or bachelor’s degree in HIM

 

Experience

  •  CCS, RHIA, RHIT credential. AHIMA credential preferred

We believe those that exceed in this role also exhibit these characteristics: High standard of creative prioritization skills and priority setting. Shown focus on customer service/patient service with every interaction. Excellent public relations and interpersonal/communication skills. Work as an effective team member to deliver outstanding care. Ability to use appropriate computer applications. Capable of working independently, demonstrate critical thinking skills. Ability to accept change and empower those around you to engage in ongoing process improvement. A solid understanding of Dignity, Integrity, Service, Compassion and Innovation.

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