Senior Outpatient Coder

Key Responsibilities:

• Evaluates health record documentation and accurate reimbursement by ensuring that ICD-10-CM diagnostic and CPT/HCPCS procedural codes, and modifiers accurately reflect and support the hospital-based outpatient encounter
• Identifies documentation clarification opportunities to ensure that documentation supports the coding and charges for the services provided. Initiates coding queries and provides feedback to clinicians
• Reviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided
• Works with the coding denials team for education and assists with denial prevention solutions
• Ensures outpatient accounts are coded accurately and in a timely manner
• Consistently maintains coding quality (95% accuracy) and productivity expectations
• Assists with the training of outpatient coders
• Performs related duties as required

Educational Requirements:

• Successful completion of a coding program, which included coursework in ICD-10-CM, CPT/HCPCS, medical terminology, anatomy and physiology and disease processes

Required Qualifications:

• Two (2) years of hospital outpatient coding experience

• Passing score on the Essentia Health senior outpatient coding skills assessment

Preferred Qualifications:

Certification/Licensure Requirements:

• Current certification with American Health Information Management Association (AHIMA) or AAPC and credentialed as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), and/or Certified Coding Specialist-Physician-Based (CCS-P)