Outpatient Coder

Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for billing, internal and external reporting, research, and regulatory compliance.  Demonstrate knowledge of reimbursement methodologies and apply these to assigned charts to optimize reimbursement and/or resolve regulatory edits.   Resolve error reports associated with the billing process, identify and report error patterns, and, when necessary, assist in the design and implementation of workflow changes to reduce billing errors.

• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines, and keeps abreast of coding changes and interpretation of codes.
• Performs detailed review of Inpatient record documentation to identify & assign diagnosis & procedure codes using ICD-10-CM and ICD-10-PCS.
• Meets established departmental productivity guidelines with 95% accuracy on a consistent basis.
• Utilizes Care Connect, UDS, and Clintegrity systems proficiently to obtain ICD10 codes and DRG assignment.
• Formulates compliant Physician Coding Queries when documentation is inadequate, ambiguous, or unclear for coding purposes.
• Corrects failed claim errors to billing edits, accounts misclassified and/or other errors identified through various auditing processes in a timely manner.
• Provide assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process.

• One of the following certifications is required: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder Hospital Based (CPC-H), Certified Medical Coder (CMC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder Apprentice CPC-A, or a specialty coding certification.
• Candidates with an Associate degree from an accredited American Health Information Management Association (AHIMA) are required to sit for the Registered Health Information Technician (RHIT) exam within 1 year of hire.
• At least 2 years of progressive coding experience in a hospital or multi-specialty physician practice setting preferred.
• Full CPC certification must be obtained within 24 months if employee holds CPC-A from the American Academy of Professional Coders (AAPC) at time of hire.
• For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification required within 16 months of hire.

The posted pay range is a good faith representation of potential base pay for this position. It may be modified in the future and eligible for additional pay components. Individual annual salaries/hourly rates could vary based on position details and FTE. Pay is determined by considering factors including, but not limited to, experience, relevant qualifications, specialty, internal equity, locations, and contracts.