Job Description:
The Outpatient Coder is responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare & Medicaid Services (CMS) directives across network. Performs data entry of required abstracted patient information into the electronic medical record system. Queries physicians when appropriate.
This is a remote position.
Responsibilities
A day in the life of an Outpatient Coder IV includes:
- Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines and coding conventions.
- Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.
- Analyzes medical records and identifies documentation deficiencies.
- Reviews and verifies documentation supports existing diagnoses, procedures and other charges.
- Identifies reportable elements, complications, and other quality measures.
- Communicates with physicians to clarify information via the physician query process
- Assign CPT, HCPCS and ICD-10-CM codes.
- Knowledge of and ability to address National Correct Coding Initiative (NCCI) and National Coverage Determinations (NCD) / Local coverage determinations (LCD) edits.
- Maintains required productivity and quality requirements.
- Other duties and/or projects as assigned.
- Adheres to Organizational competencies and standards of behavior.
Qualifications
Education, Knowledge, Skills and Abilities Required:
- High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
- Minimum of 3+ years of coding experience, Trauma Level 1 and Academic Teaching facility.
- Strong understanding of physiology, medical terms and anatomy.
- Proficiency in computer skills including typing speed and accuracy.
- Excellent written and verbal communication skills.
- Proficient computer skills including but not limited to Microsoft Office and Google Suite platforms.
- Proficient in coding Ancillary Accounts such as Diagnostic Radiology and Cardiology
- Proficient in coding Emergency Department and Infusion based services such as Oncology.
- Proficient in coding Observation and Procedure Room such as Endoscopies and Cardiac Cath.
- Proficient in coding all outpatient services especially Operating Room procedures.
Licenses and Certifications Required:
- Certified in at least one of the following: American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC)