Coder I Outpatient

Primary City/State: Virtual - Arizona Category: Health Information Shift: Day Department: Coding Outpatient Coder I Great care starts with great people. (Like you.) At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area. Responsibilities: JOB SUMMARY Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT and HCPCS codes through review of inpatient or outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. ESSENTIAL FUNCTIONS Inpatient: • Assigns and sequences ICD-10-CM and ICD-10-PCS diagnostic and procedural codes for inpatient accounts within HonorHealth. • Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. • Utilizes electronic medical record and computer-assisted coding (CAC) software. • Addresses applicable coding edits. • Assigns DRGs as applicable. Outpatient: • Assigns and sequences ICD-10-CM, CPT and HCPCs diagnostic and procedural codes for outpatient accounts within HonorHealth. • Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. • Utilizes electronic medical record and computer-assisted coding (CAC) software. • Addresses NCCI, OCE, LCD, and other applicable coding edits. Inpatient: • Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. • Reviews and analyzes medical records for accurate ICD code selection. Outpatient: • Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. • Reviews and analyzes medical records for accurate ICD and CPT code selection. Inpatient/Outpatient: • Communicates and assists in education with an audience that may include physicians and clinical staff. Inpatient: • Assists Patient Financial Services with interpretation and selection of appropriate ICD codes and /or other information requested for accurate billing and reimbursement. • Possesses knowledge and understanding of failed bill parameters. Outpatient: • Assists Patient Financial Services with interpretation and selection of appropriate ICD, CPT, and HCPCs codes and /or other information requested for accurate billing and reimbursement. • Possesses knowledge and understanding of failed bill parameters. Inpatient/Outpatient: • Performs outpatient charge validation/reconciliation for outpatient coding to ensure all submitted charges are posted timely and balance with total submitted charges. • Assigns charges as applicable. Inpatient/Outpatient: • Resolves routine coding issues/problems and appropriately seeks assistance from supervisor. Performs other duties as assigned. EDUCATION High School Diploma or GED Required Associates in health related field Preferred EXPERIENCE Other Inpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM and ICD-10-PCS codes. Required or Other Outpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM, CPT, and HCPCs codes. Required 2 years Inpatient: Hospital inpatient coding. Preferred or 2 years Outpatient: Coding outpatient accounts which may include Emergency department, newborn, obstetrics, day surgery, observation, wound care, radiology, laboratory, series, infusion, oncology, and rehab therapy. Preferred Other Inpatient: Knowledge of pathology, pharmacology, microbiology, radiology, and other clinical specialties. Preferred or Other Outpatient: Working knowledge of charging and billing processes. Working knowledge of Medicare, NCCI, OCE, LCD, NCD, and other claim edit guidelines and protocol. Preferred LICENSE AND CERTIFICATIONS CCA (Certified Coding Apprentice) with successful certification of CCS in 6 months Required or Inpatient: CCS (Certified Coding Specialist), or CIC (Certified Inpatient Coder), or RHIT () or RHIA (Registered Health Information Administrator) Required Outpatient: CPC-H (Certified Professional Coder-Hospital Outpatient), or CPC (Certified Professional Coder), or COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist), or RHIT () or RHIA (Registered Health Information Administrator) Required CPC-H/COC, CIC, RHIT, or RHIA Preferred We're all in for your career.