Certified Surgical Coder

About the role

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. Our culture, known as The Meaning of Care, sets us apart by helping families grow through special deliveries, conveying difficult diagnoses with compassion, going above and beyond for patients' needs, and celebrating personal health challenges.

We offer competitive pay, excellent benefits, and a great work environment where all employees are valued. Our employees are part of a team that makes a real difference in the communities we live and work in.

Responsibilities

• Assigns ICD-10-CM diagnosis, Current Procedural Terminology (CPT) procedure codes, and Healthcare Common Procedure Coding System (HCPCS) device codes as necessary to outpatient records to ensure maximum reimbursement, utilizing ICD-10-CM and Current Procedural Terminology (CPT) principles of code assignment and Uniforms Hospital Discharge Data Set (UHDDS) definitions of principle and secondary diagnosis.
• Accuracy rate of at least 95%.
• Enters ICD-10-CM diagnosis code(s) and Current Procedural Terminology (CPT) procedure code(s) into the code summary to maintain disease and operation index, to allow for timely submission of claims to insurance companies by assigning correct diagnosis and procedure codes and the reason for the encounter per department procedure.
• Accuracy rate of at least 95%.
• Reviews Current Procedural Terminology (CPT) procedure codes and Healthcare Common Procedure Coding System (HCPCS) device codes in the code summary and charge viewer to ensure all accounts reflect appropriate charges for services and devices provided; by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account.
• Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates.
• Reviews coding with Provider 95% of the time. Per provider request. Per departmental audit standards.
• Investigates claim denials from third party payers to ensure accuracy by reviewing services patient received and patient account and making any coding/charging corrections. Per department process regarding code reviews within 14 days of receipt. Per request from clinic personnel. Per request from Business Office and/or Customer Service Personnel.
• Ensures Timely Submission Of Claims To Insurance Companies By Performing Job Functions #1 By Maintaining Accounts Receivable Within 3 Days Of Discharge On All Outpatient Encounters.
• Maintains a Minimum Productivity Standard Of Codes 7 OPS encounters per hour. Codes 5 OBS encounters per hour. Codes 12 Infusion Center encounters per hour. Codes 10 GI/Pain Management encounters per hour. Codes 30 Radiology/OP Diagnostic services encounters per hour. Codes 15 Recurring encounters per hour. Codes 30 Radiology/OP Diagnostic services encounters per hour. Codes 25 Non-patient Pathology Encounters per hour. Codes 15 Emergency Department encounters per hour. Codes 12 Professional Services encounters per hour.
• Utilizes and understands how to view and make appropriate changes in charge viewer to ensure maximum reimbursement.

Requirements

• Education: High School Diploma or General Educational Development (G.E.D) required. College level completion of courses in anatomy and physiology, biology, disease process, and medical terminology required. Associate's Degree in Health Information Management or healthcare related degree preferred.
• Experience: 3+ years previous experience coding physician services from documentation preferred, surgical and Evaluation/Management (E/M) required.
• Licenses/Certifications: Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Registered Health Information Tech (RHIT) or certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) required.

Skills/Knowledge/Abilities

• Ability to note detail when reviewing the medical record, verifying the diagnosis and reviewing charges at the time of ICD-10-CM and Current Procedural Terminology (CPT) code assignment.
• Understanding of outpatient prospective payment methodology, and knowledge of the national correct coding initiatives.
• Skills necessary to operate a personal computer and Microsoft Office programs.
• Experience with personal computer and knowledge of Word, Excel, etc.

Physical Requirements

• Weight Demands: Light Work - Exerting up to 20 pounds of force.
• Physical Activity: Not necessary for the position (0%): Climbing, Crawling, Kneeling, Occasionally Performed (1%-33%): Balancing, Carrying, Crouching, Distinguishing colors, Lifting, Pulling/Pushing, Standing, Stooping/bending, Twisting, Walking, Frequently Performed (34%-66%): Grasping, Reaching, Repetitive Motions, Sitting, Speaking/talking, Constantly Performed (67%-100%): Fingering/Touching, Keyboarding/typing, Seeing/Visual

About Nebraska Methodist Health System

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Employer Information

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.