Coder I - OP & IP Profee, Neurosurgery

JOB SUMMARY

• Coder I is proficient in one or two types of outpatient or profee coding.
• Coder I may code one time ancillary/series, emergency department, observation, day surgery, professional fee to include evaluation and management (E/M) coding, profee surgery, hierarchical condition category (HCC) Risk Adjusted coding (diagnosis only with 1 year lookback) or low acuity inpatient.
• Coder I utilizes the International Classification of Disease (ICD-10-CM, ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding.
• Coder I will abstract and enter required data.

WORK MODEL

• Onsite with the possibility of moving to a hybrid role after training has been signed off, but will not be 100% remote.

ESSENTIAL FUNCTIONS OF THE ROLE

• Evaluates and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees.
• Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
• Communicates with providers for missing documentation elements and offers guidance and education when needed.
• Reconcile billing issues by formulating the rationale for rejecting and correcting inaccurate charges.
• Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately. Reviews and edits charges.

KEY SUCCESS FACTORS

• Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
• Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
• Sound knowledge of anatomy, physiology, and medical terminology.
• Demonstrated expertise of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
• Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
• Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
• Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.

BENEFITS

Our competitive benefits package includes the following:

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or level.

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 1 Year of Experience
  • This position is not under the Coding umbrella but an outpatient practice therefore, some sort of coding experience is required.
• CERTIFICATION/LICENSE/REGISTRATION -
  • Cert Coding Assoc.
  • Cert Coding Specialist
  • Cert Coding Specialist-Phys
  • Cert Inpatient Coder
  • Certified Inpatient Coder - Apprentice
  • Cert Outpatient Coder
  • Cert Outpatient Coder - Apprentice
  • Cert Prof Coder
  • Cert Prof Coder-Apprentice
  • Cert Prof Coder-Phys
  • Home Care Coding Spec-Diagn
  • Reg Health Info Admin
  • Reg Health Info Technician
  • Radiation Oncology Certified Coder HCS-D is valid in Home Health Care Department only.