Hospital Based Outpatient Coder II - HIM - FT - Days - MSS - Remote Eligible

Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.

Responsibilities

Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters; Routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing; Reviews chargemaster generated CPT/HCPCS codes and notifies Coding Management when errors are found; Enhances and maintains coding knowledge and skills for physician billing; Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements; Communicates with insurance companies about coding errors and disputes for physician billing; Reviews and validates accuracy of data in Admission-Discharge-Transfer (ADT) fields following HIM coding policies and procedures; Reviews CRW documentation to assign correct discharge disposition; Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements; Practices ethical coding per AHIMA Standards of Ethical Coding; Meets and maintains HIM coding quality and productivity standards; Submits daily productivity report to HIM manager by defined deadline; Reviews encounters to assign and sequence appropriate diagnoses including HCC and CPT procedure codes and modifiers; Reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments; Reviews coding edits and Local Coverage Determination (LCD) edits; Reviews all appropriate work queues daily to address edits and make corrections; Conducts audits and/or coding reviews with healthcare professionals; Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding; Creates electronic physicians queries within allowed scope for hospital outpatient coder

Requirements

High School Diploma or Equivalent (Required); Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA); Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA); Registered Health Information Technician (RHIT) - State of Florida (FL); Registered Health Information Technician (RHIT AHIMA) - American Health Information Management Association (AHIMA); Two (2) years of hospital-based outpatient coding experience or a graduate of the internal MHS Coder Intern Program; For Physician Billing coder, two (2) years of higher complexities of diagnostic/procedural/office coding experience; Completion of coding training program; For HIM: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS); For Physician Billing: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, Certified Coding Specialist (CCS), or Certified Coding Specialist - Physician Based (CCSP) by AHIMA; Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work independently with minimal supervision; Proficient in basic computer skills including Microsoft Office applications, computerized encoder, and electronic medical record systems; Requires a strong proficiency and understanding of Medical Terminology, Anatomy & Physiology, Pathophysiology and Pharmacology; Knowledge of coding classification systems and procedures