Coder II

About the Role

Responsible for coding inpatient or outpatient records review documentation and properly identifying and assigning ICD-10-CM, CPT-4/HCPCS, and/or ICD-10-PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions, and surgical procedures.

Responsibilities

• Perform outpatient coding and charge validation (charge entry) in multiple specialties.
• Code records with lengths of stay (LOS) both under and over 30 days.
• Review, identify, and assign ICD-10-CM, CPT-4 with charge validation, and ICD-10-CM/ICD-10-PCS codes.
• Apply appropriate soft codes for evaluation and management levels, observation hours, injections, infusions, and other procedures.
• Validate CPT-4 codes (charges) captured by departments, including hard-coded charges for specific encounters.
• Research and investigate National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) guidelines related to modifier assignment to ensure clean claim submission.
• Determine the correct principal diagnosis, co-morbidities, complications, secondary conditions, and surgical procedures.
• Meet or exceed the established quality standard of 95% accuracy while meeting or exceeding production standards.

Requirements

• Associate’s degree in HIT, Applied Science, Liberal Arts, or other healthcare-related field.
• 2 years of Facility Inpatient, Outpatient, or Professional Coding experience.
• Certification in one of the following:
  • AHIMA Certification (e.g., RHIA, RHIT, CCS)
  • AAPC Certification (e.g., CPC, CCC, COC, CIC, CHONC)
  • AMAC Certification (e.g., ROCC - Radiation Oncology Certified Coder)

Preferred Qualifications

• 3 years of Facility Inpatient, Outpatient, or Professional Coding experience.

Schedule

Full-time, 8:00 AM – 4:30 PM, 80 hours per pay period. No on-call or weekend shifts.