Outpatient Coder

Responsibilities

• Assigns appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other information
• Ensures all coding is completed in a timely manner to meet billing deadlines
• Affords assistance in resolving incomplete and/or missing documentation in order to expedite billing
• Communicates with healthcare providers to clarify coding questions and concerns
• Performs Claim edit corrections and Denial reviews related to coding errors
• Identifies coding or documentation trends that may pose a risk to revenue stream and reports such trends to management team
• Stays abreast of coding and documentation guidelines, compliance policies, annual coding updates, payer policies and industry changes
• All other duties as assigned

Requirements

• Knowledge of ICD-CM (current edition) CPT, HCPCS coding systems as well as CCI edits
• Knowledge of third-party payer requirements, federal and state guidelines and regulations on medical coding and billing
• Knowledge and understanding of current ICD-10-CM and CPT/HCPC Official Guidelines for Coding and Reporting
• Knowledge of medical records content and management
• Working knowledge of the EMR either through experience or education
• Medical terminology knowledge
• Knowledge of laws and regulations about health information and patient confidentiality
• Proficient in Microsoft office applications such as Excel, Word and PowerPoint
• Demonstrating flexibility with respect to changing end-user business needs
• Good interpersonal and communications skills and demonstrates professionalism when working with team members, management and other staff members.
• The ability and willingness to take ownership of work activities and ensure that they are completed in an accurate, efficient, and timely manner
• The ability and willingness to learn new software and systems
• The ability to determine a problem’s cause and develop a course of action to resolve the problem and to prevent its recurrence
• The ability to persevere in difficult situations and overcome obstacles

Qualifications

• High School Diploma or equivalent required
• CPC Certification required
• 3-5 years CPT/HCPC Outpatient coding experience, preferably in a multi-specialty facility
• Prior Epic experience highly preferred