Position Summary:
Remote position responsible for coding complex hospital outpatient records (Outpatient Coder III) review documentation and properly identifies and assigns ICD-10-CM, CPT/HCPCS and/or PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures.
This includes utilizing technical coding principals and APR and/or MS-DRG reimbursement expertise to assign appropriate ICD-10-CM diagnoses and PCS procedures, as well as abstracting these code assignments according to facility guidelines. Works collaboratively with CDI, understand Potentially Preventable Complications (PPC's)/ Hospital Acquired Conditions (HAC's), Prevention Quality Indicators (PQI's) to ensure accurate APR-DRG/SOI/ROM and their impact and other indicators as needed. This includes utilizing technical coding principals and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT procedures, as well as abstracting these code assignments according to facility guidelines
Essential Functions and Responsibilities:
Coding experience of:
Outpatient Coder III will be responsible for coding and charge validation (charge entry):
Observation, Complex Same Day Surgery, Infusion, or
Cath lab, IR, or
Hem/ONC, Rad/ONC, or
Procedure coding for Pain Management, Wound Care or
Professional Specialty Coding, Specialty Surgery or
CCI/NCCI Edits and Denials expert knowledge, inclusive of review and resolution of pre-bill and post-bill edits, inclusive of review of denials and writing appeal letters
Inpatient Coder III will be responsible for coding:
Complex Inpatient visits (inclusive of < 30 days of LOS and >30 days of LOS)
Denials and Appeals expert knowledge, inclusive of review and resolution of pre-bill and post-bill edits, inclusive of review of denials
Expert ability to correctly abstract required data per facility specifications.
Expert ability to perform medical necessity for Medicare and other payers as required per payment guidelines.
Required:
Associates degree in HIT or closely related field
Five years of Facility Inpatient or Outpatient Coding experience.
RHIT (Registered Health Information Technician (AHIMA) or CCS (Certified Coding Specialist (AHIMA) certification
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
