Outpatient Coder III

Description

Summary:

Accurately codes and abstracts outpatient medical records for reimbursement and statistical purposes using established coding guidelines. Reviews coding and amends coding edits to assure compliance with all applicable regulations. Position requires advanced knowledge of complex surgical procedures and a working knowledge of evaluation and management guidelines.

Responsibilities:

1. Codes all outpatient medical records in a timely and accurate manner according to department policy. 2. Defines and transforms verbal descriptions of diseases injuries and procedures into numerical designations (codes) using ICD-10-CM and CPT-4 according to established coding guidelines 3. Initiates a physician/department query when there is conflicting incomplete or ambiguous documentation in the record or additional information is needed for accurate coding. 4. Enters all required information accurately into computer system for reimbursement and statistical purposes 5. As applicable based on facility workflow independently reconciles charge for areas of responsibility. Uses patient schedule together with billing slips t identify missing charges. Researches and resolves discrepancy so charge keyed reflect services delivered. 6. Performs ICD-10-CM diagnostic and CPT-4 at a minimum accuracy rate of 95% 7. Remains abreast of all applicable Federal State regulatory and hospital-specific coding guidelines. 8. Applies applicable guidelines to all cases coded to ensure accuracy of selected codes 9. Accesses and research applicable reference materials to further support decision-making in code selection. 10. Mentors less experienced coding personnel 11. Participates in Performance Improvement/Quality Assurance activities 12. Reports on software and hardware problems. 13. Attends required educational sessions (webinars conferences etc.) to maintain and enhance coding certification(s) 14. Maintains and Model the Organizationï½s values. 15. Demonstrates regular reliable and predictable attendance. 16. Performs other duties as required.

Requirements:

• Minimum of five (5) years of experience in at least two to three of the following areas (facility-based): Observation Surgery or Radiology.
• Must have CPC or CCS AAPC
• This role represents the highest level within our staff coding team. Applicants should meet all required qualifications to be considered.

Working Conditions:

Manual: Some manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Nuvance Health

Org Unit: 2070

Department: Coders

Exempt: No

Salary Range: $29.65 - $55.55 Hourly