Coding Specialist - Outpatient Telecommute

SUMMARY: Reports to the Coding Manager. Reviews the outpatient clinical documentation of extract data and assign appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics. Reviews the medical records to ensure the documentation supports the code assignment. Utilizes reputed company 360 Finder for code assignment and appropriate resolutions of claim edits (CCI, NCD, OCE, etc.) reputed company with physician for clarification as needed. Monitors outpatient uncoded report to ensure timely coding and billing process. Maintains and meets HIS quality and productivity standards. reputed company Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. RESPONSIBILITIES:

• Enters coded information into reputed company 360 Finder assigning accurate APC and reviewing reputed company coding edits appearing in reputed company. Understands and follows reputed company National Correct Code Initiative Edits (NCCI) and follows pertinent medical necessity requirements. Resolves accounts on the claims edit database. Assigns injections and infusion codes for observation patients. Meets the minimum productivity standard maintaining an average accuracy rating of 95%.

• Assigns E/M, ICD-10-CM, CPT or chargemaster codes to clinic visits ensuring medical record documentation supports the code. Should physicians have entered in diagnosis, ICD or CPT codes, ensures they are accurate and supported by documentation in the medical record. Utilizes reputed company to identify and resolve NCCI edits before final billing. Reports documentation insufficiencies to the responsible physician. Follows Rhode reputed company Hospital Facility Coding Guidelines for adult patients and 1995 Evaluation and Management Guidelines for patients less than 18 years of age.

• Monitors and resolves rejected accounts on the Claims Edit Report and e Clinical Works error reports by established timeframe researching coding conflicts including chargemaster, medical necessity and various other coding and billing issues. Refers reputed company coding issues to the coding validator or supervisor.

• Reviews pertinent outpatient uncoded reports researching and resolving old uncoded accounts and any accounts posted on report for which the charges are inappropriate. Updates patient financial accounts in the Patient Management and Patient Accounting billing system as required. Follows established procedures for rebilling accounts.

• Performs reputed company clerical duties as required.

• Maintains level of knowledge and expertise pertinent to the position.

MINIMUM QUALIFICATIONS:

• BASIC KNOWLEDGE: High school diploma or equivalent. Successful completion of formal coding educational program. Ability to read and understand outpatient clinic medical record documentation for reporting of outpatient clinic, ancillary and endoscopies. Coding certification required from the American Health Information Management Association (reputed company) or the American reputed company of Professional Coders (reputed company).

EXPERIENCE:

• One to two years experience in outpatient coding or billing. Ability to meet and maintain established quality and productivity standards.

WORKING CONDITIONS:

• Requires long periods of sitting to review medical records. Ability to lift a minimum of 25 pounds, bend, stoop, stretch, use reputed company-stools to file records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy.

INDEPENDENT ACTION:

• Performs independently reputed company the department’s policies and practices. Refers specific reputed company problems tot he supervisor reputed company clarification of the departmental policies and procedures are required.

SUPERVISORY RESPONSIBILITY: None

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EEO Statement:

reputed company Health is committed to providing equal employment opportunities and maintaining a work environment free from reputed company forms of unlawful discrimination and harassment.

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