Coder II Remote Coder Full Time Experience in coding needed
Company: Hendricks Regional Health
Location: Danville
Posted on: January 27, 2023
Job Description:
Job Summary : The Level II, Outpatient Coder, serves the needs
of patients, associates, physicians and third-party payers
performing the highest quality, accurate, and efficient review of
outpatient records including but not limited to ambulatory surgery,
minor surgery, infusion, therapy, emergency room, imaging, lab and
observation records, translating the clinical content, diagnoses
and procedures, to ICD- 10-CM and CPT codes. This position reports
to the Manager of the Health Information Management Department.
REMOTE OPPORTUNITY AVAILABLEJob DescriptionEssential
Responsibilities:
- Organizes and prioritizes complex coding work to ensure
compliance with regulatory requirements and hospital targets.
- Reviews and analyzes the outpatient medical record to assign
International Classification of Diseases (ICD-10-CM), CPT and/or
Healthcare Common Procedure Coding System (HCPCS) codes, and
modifiers to reflect the utilization of resources during the
patient encounter, in compliance with state and federal
guidelines.
- Accurately assigns ICD-10-CM diagnoses and CPT procedure codes
for same day surgery, observation, OIB (outpatient in a bed) ,
emergency room and other outpatient services within the acceptable
range of productivity levels established by HRH HIM.
- Reviews and resolves claim-based coding edits related to
diagnoses, procedures, and other services for the specific
encounter including those for medical necessity.
- Responsible for monitoring the assigned DNFC work queue. Coding
as well as reviewing, and correcting when possible, failed claims,
stop bills, individually and as a team, to ensure timely, compliant
processing of outpatient accounts.
- Recognizes documentation clarification opportunities to ensure
that the documentation supports all codes and designation
assignments.
- Consults with physicians and/or clinical department
representative via coding queries, as appropriate, to resolve any
incomplete, confusing, or conflicting information to verify
services were rendered, documented and meet the requirements for
coding as an ambulatory service.
- Responsible to ensure accuracy of 95% quality standard and
maintain 5/hr. for SDS/OBS, 10/hr. for ED productivity
standard.
- Identifies and escalates to Coding Leadership any variance from
ethics, accuracy or other impacts to timely processing to resolve
any avoidable delays in billing and reimbursement.
- Remains abreast of Official ICD-10-CM Official Guidelines for
Coding and Reporting, the Current Procedural Terminology (CPT)
guidelines, The Coding Clinic and Centers for Medicare and Medicaid
Services (CMS) requirements, including payor coverage documents,
LCA, and NCD.
- Serves as a clinical coding subject matter expert for
outpatient services including Emergency Department, surgical coding
and other outpatient services.
- Proficient with Office 365 applications, specifically MS Word,
Excel, Teams and Outlook.
- The Level II coder may be assigned the work of lower-level
coder designations when needs arise.Technical Capabilities:
- MEDICAL CODING (ADVANCED):- The transformation of healthcare
diagnosis, procedures, medical services, and equipment into
universal medical alphanumeric codes.
- MEDICAL TERMINOLOGY & DOCUMENTATION (ADVANCED):- The ability to
comprehend medical terminology and documentation in an office, or
surgical setting.
- CRITICAL THINKING (ADVANCED):- The objective analysis and
evaluation of an issue in order to form a judgment.
- COMPLIANCE (ADVANCED):- Understanding the rules, regulations,
sanctions and other statutory requirements, guidelines and
instructions relating to governing bodies and organizations, both
internally and externally.
This job description is not designed to cover or contain a
comprehensive listing of activities, duties or responsibilities
that are required of the associate for this job. Duties,
responsibilities, and activities may change at any time with or
without notice.Education/Experience Required:
- High School graduate or equivalent.
- Minimum of two years ICD-10-CM and CPT coding experience in an
acute-care hospital setting.
- Advanced intermediate ICD and CPT coding proficiency. To assist
with this and during the interview process, HRH will require
potential candidate(s) to take an OP coding test to gauge overall
knowledge and proficiency in coding. This testing will only occur
after the HIM Manager and/or Revenue Cycle Director has interviewed
a potential candidate and is ready to move to this next stage.
Target accuracy rate would be 95%.Licenses or Certifications:
- CCS (AHIMA Certified Coding Specialist), COC (AAPC Certified
Outpatient Coder), or CPC (Certified Professional Coder) is
required.
- (Those that have been with Hendricks Regional Health for 15
years or more and in this job classification for 2 years or more
will be grandfather from this certification requirement.)Work Shift
: 1st Shift (United States of America)Scheduled Weekly Hours :
40
Keywords: Hendricks Regional Health, Indianapolis , Coder II Remote Coder Full Time Experience in coding needed, Other , Danville, Indiana
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