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Telecommute Outpatient/Inpatient Coder II
2 months ago
Position: Hospital-Based Coder II, Full-Time, Remote Work Opportunity, Health Information Management
Overview:
This role involves the meticulous review of medical record documentation to accurately assign ICD-10 CM codes for intricate diagnoses and CPT codes along with modifiers for outpatient encounters, ensuring compliance with coding and billing standards.
Key Responsibilities:
• Conduct thorough reviews of encounters to assign and sequence the correct diagnoses and procedure codes, including modifiers for complex diagnostic and surgical cases, adhering to Official Coding Guidelines, CMS regulations, Local Medical Review Policies (LMRP), and HIM coding protocols.
• Utilize encoder software to analyze Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Review coding edits and Local Coverage Determination (LCD) edits to ensure medical necessity for codes.
• Collaborate with healthcare providers or designated resources to clarify documentation and ensure precise and comprehensive coding.
• Monitor daily work queues to address coding edits and implement corrections in line with Health Information Management (HIM) policies.
• Engage in audits and coding reviews with healthcare professionals to verify the accuracy of documentation for physician billing.
• For hospital encounters, identify and rectify billing charge entry errors and account edits that hinder coding and billing completion. Communicate necessary coding adjustments and follow established procedures for billing notifications.
• Liaise with insurance companies regarding coding discrepancies and disputes related to physician billing.
• Validate the accuracy of data in Admission-Discharge-Transfer (ADT) fields, following HIM coding standards.
• Adapt to ongoing changes in the coding landscape while practicing ethical coding in accordance with AHIMA Standards of Ethical Coding.
• Meet and uphold HIM coding quality and productivity benchmarks, submitting daily productivity reports to the HIM manager within set deadlines.
• Participate in internal and external educational sessions to fulfill certification and continuing education obligations.
• Enhance and sustain coding knowledge and skills pertinent to physician billing.
• Uphold strict patient confidentiality in compliance with MHS standards and regulatory mandates.
• Perform additional duties as assigned.
Qualifications:
• High School Diploma or Equivalent.
Certifications:
• Coding Certification (RHIT, RHIA, CCS).
Work Complexity:
This position demands critical thinking, effective communication, sound judgment, and the ability to work autonomously with minimal oversight. Candidates must thrive in a high-pressure environment and demonstrate proficiency in basic computer skills, including Microsoft Office, computerized encoder, and electronic medical record systems. A robust understanding of Medical Terminology, Anatomy & Physiology, Pathophysiology, and Pharmacology is essential, along with knowledge of coding classification systems and procedures. A solid foundation in coding and clinical knowledge is required to review, research, and code complex diagnoses and procedures.
Experience:
• A minimum of two (2) years of hospital-based outpatient coding experience and possession of either Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) credentials.
