Coder Outpatient

ESSENTIAL FUNCTIONS:

• Assign appropriate diagnosis and procedure codes utilizing ICD 10-CM, CPT, and HCPCS according to the Centers for Medicare & Medicaid Services (CMS) requirements for hospital billing.

• Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.

• Must be familiar with Ambulatory Payment Categories (APCs, the Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) guidelines, Local and National Coverage Decisions, and other medical necessity/compliance guidelines for billing and coding.

• May verify, edit and/or enter charges based on documentation or payer/billing.

• Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the coding area.

• Follow coding workflows for service type to include addressing compliance reviews.

• Submit physician queries when clarification of documentation is needed.

• Facilitate a positive working relationship with physicians, nurses, medical staff, and hospital employees to ensure that all work-related encounters are productive.

• May assist in training and reviewing the work of other coders for accuracy and efficiency.

• Make recommendations to the supervisor, and implement and monitor results as appropriate in support of the overall goals of the department.

• Seek advice and guidance as needed to ensure proper understanding.

• Assist others with responsibilities and adjusts work schedule to meet department needs.

• Use independent discretion/decision-making while effectively working remotely.

• Attend required educational webinars, conference calls, and other coding seminars, and participate in all formal and informal coding discussions.

• Maintain coding education hours and renew annual coding credentials as applicable.

• Complete all assigned compliance courses within the designated period.

• Conform to AHIMA’s Code of Ethics and Standards of Ethical Coding, LifePoint Attendance Policy, and ensure patient/employee privacy and dignity by maintaining confidentiality with no infractions.

• Other related job tasks or responsibilities as assigned.

Additional Information:

The position serves internal co-workers and external customers, clients, and contractors.

Access to and/or work with sensitive and/or confidential information.

KNOWLEDGE, SKILLS & ABILITIES:

The requirements below represent the required knowledge, skills, and/or abilities.

Certifications: Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) preferred.

Coder must be able to code all OP chart types: Amb Surgery, Observation, Ancillary, Wound Care and ED.

Client trains on each system and site.

Systems: Meditech