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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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