Coding Specialist-Outpt

About the role

The position is open to remote candidates residing in Nevada, Texas, Arizona, Utah, Florida, Idaho, Oregon, or Washington. Due to business operations, tax registration, and employment compliance requirements, we are only able to hire individuals who currently live and work in these states. Applicants must maintain residency in one of the approved states as a condition of employment.

Responsibilities

• Accurately assign ICD-10-CM diagnostic codes and procedural CPT codes by proficiently translating diagnostic statements, physician orders, and other pertinent documentation.
• Lead to coding accuracy and abstracting of pertinent data elements from documentation provided to report and code for reimbursement.
• Identify appropriate charges based on documentation and coding guidelines.
• Work in conjunction with HIM staff to utilize the appropriate physician clarification process to obtain additional information that provides a codable sign, symptom, or diagnosis and/or physician order when documentation or a valid order is incomplete, vague, ambiguous, or missing.
• Apply clinical knowledge of disease processes, physiology, pharmacology and surgical techniques by reviewing and interpreting all clinical documentation included in an inpatient record.
• Interpret and apply American Hospital Association (AHA) Official Coding Guidelines to articulate and support appropriate principal, secondary diagnoses and procedures.
• Maintain coding certification and knowledge referencing current ICD-10-CM coding guidelines and regulatory changes.
• Clarify physician documentation by utilizing facility established query process.
• Participate in performance improvement initiatives as assigned.
• Provide education and support to clinical areas in regard to appropriate documentation and code assignment.
• Consistently meet or exceed productivity and quality standards as defined by department Leadership.

Requirements

• Knowledge of Anatomy and Physiology, Pharmacology, Disease Pathology, and Medical Terminology.
• Knowledge of basic coding conventions and use of coding nomenclature consistent with CMS Official Guidelines for Coding and Reporting ICD-10-CM coding.
• Ability to navigate the Electronic Medical Record to identify appropriate documentation for coding/billing in support of submitted department charges.
• Knowledge of clinical content standards.
• Utilize critical thinking and problem-solving abilities.
• Ability to work well with others.
• Personal time management skills, including organization, prioritization, and multitasking.

Skills & Abilities

• Knowledge of ICD-10-CM coding guidelines and regulatory changes.
• Ability to translate written diagnostic descriptions to appropriately and accurately assign ICD-10-CM diagnostic codes and procedural CPT codes to obtain optimal reimbursement from all payer types, including Medicare/Medicaid, and private insurance payers.
• Experience in acute care facility outpatient and/or Trauma Level II coding preferred.