Outpatient Coding Specialist I - III Remote Work Schedule - Hospital Rev Cycle

Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction. ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state. Our vision: Alaska Native people are the healthiest people in the world.

Benefits

• Medical Insurance provided through the Federal Employee Health Benefits Program as a Tribal Employee, with over 20 plans and tiers
• Cost-Share Dental and Vision Insurances
• Discounted Pet Insurance
• Retirement Contributions with Pre-Tax or Roth options into a 403(b)
• 401(a) ANTHC Retirement Plan: After one year of employment, ANTHC will begin making matching contributions of up to 5% of your eligible pay, based on your own contributions. In addition, you may be eligible for an annual discretionary contribution of up to 3% from the employer
• Paid Time Off starts immediately, earning up to 6 hours per pay period, with paid time off accruals increasing based on years of service
• Eleven Paid Holidays
• Paid Parental Leave or miscarriage/stillbirth eligibility after six months of employment
• Basic Short/Long Term Disability premiums, Accidental Death and Dismemberment (AD&D) Insurance, and Basic Life Insurance are covered 100% by ANTHC, with additional options for Short-Term Disability Buy-Up Coverage and Voluntary Life for yourself and your family members
• Flexible Spending Accounts for Healthcare and Dependent Care
• Ancillary Cash Benefits for accident, hospital indemnity, and critical illness
• On-Site Child Care Facility with expert-designed classrooms for early child development and preschool
• Employee Assistance Program with support for grief, financial counseling, mental/emotional health, and discounted legal advice
• On-Site Training Courses and Professional Development Opportunities
• License and certification reimbursements and occupational insurance for medical staff
• Emergency Travel Assistance
• Education Assistance or Education leave eligibility
• Discount program for travel, gym memberships, amusement parks, and more

Responsibilities

• Performs coding on all diagnoses, procedures, professional services, and supplies under direct supervision
• Abstracts, codes, and sequences the classification of medical and surgical procedures, professional services, diagnosis, supplies, and treatment modalities into software programs
• Selects the most accurate and descriptive codes from the listings of American Medical Association Current Procedural Terminology (CPT-4) Coding system, International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM); and Healthcare Common Procedure Coding System (HCPCS)
• Codes facility and professional components of outpatient clinic, radiology accounts, laboratory services, and ED charge capture
• Uses the most accurate codes to capture highest level of specificity for social determinants of health, reimbursement purposes, research, statistical analysis, quality of care, and communication to support the patient’s treatment
• Maintains the confidentiality of patient records and procedures
• Follows official coding guidelines to extract pertinent data from the patient’s health record, and determines appropriate coding using the official coding guidelines
• Provides feedback and education to physician and professional staff regarding changes in coding methodology and enhanced documentation procedures for optimizing reimbursement
• Sends coding queries to providers to request missing information
• Maintains electronic filing systems
• Retrieves, reviews, and compiles data for reports as directed
• Reviews and analyzes medical records to assure the record is complete and accurate, includes signatures and supporting documentation, and meets the requirements for accrediting agencies and reimbursement agencies
• Reviews and resolves system edits, MUE’s, NCCI edits, status indicators, modifiers
• Performs other duties as assigned

Outpatient Coding Specialist II

• Masters all Outpatient Coding Specialist I duties
• Provides training and mentoring to new employees as needed
• Performs routine audits independently and participates in performance improvement activities
• Provides reports of findings and feedback to parties involved
• Provides feedback and education to physician and professional staff regarding changes in coding methodology and enhanced documentation procedures for optimizing reimbursement
• Codes the facility and professional components of outpatient specialty, ED, and advanced radiology encounters

Outpatient Coding Specialist III

• Masters all Outpatient Coding Specialist I & II duties
• Performs other duties as assigned
• Codes the most complex outpatient accounts, including facility and professional components of surgical and observation accounts

Skills

• Knowledge of medical terminology and abbreviations; anatomy and physiology; major disease processes and pharmacology
• Knowledge of classification systems, including CPT-4, E&M, ICD-9-CM, and HCPCS nomenclature, coding rules and guidelines
• Knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid (CMS), AHIMA, and AAPC for assignment of diagnostic and procedural codes
• Knowledge of Health Information Management theory, principles, practices, techniques, concepts and policies
• Knowledge of the Privacy Act of 1974, The Joint Commission and HIPAA Privacy Rule Act of 1966
• Skill in understanding medical billing procedures and protocols
• Skill in linking diagnosis to services and applying appropriate codes to diagnosis, procedures, evaluation and management, and supplies
• Skill in operating a personal computer utilizing a variety of software applications
• Skill in operating computerized medical data entry and information processing systems
• Skill in oral communication and presenting information to providers
• Skill in writing reports and other materials

Outpatient Coding Specialist II Skills

• Moderate skill in training and educating Level I coders
• Ability to review accounts and provide feedback by explaining and instructing effectively

Outpatient Coding Specialist III Skills

• Advanced skill in training and educating Level I & II coders
• Ability to review accounts and provide feedback by explaining and instructing effectively
• Ability to work independently

Qualifications

• A high school diploma or GED equivalent
• Completion of a certificate program in coding through the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC)

Experience

• Outpatient Coding Specialist I: Six (6) months of practicum experience in any of the following coding classification systems: ICD-10-CM or CPT
• Outpatient Coding Specialist II: Two years of relevant coding experience
• Outpatient Coding Specialist III: Three years of relevant coding experience

Certifications

• All Levels: A minimum of one of the below certifications is required:
  • Certified Professional Coder Associate (CPC-A)
  • Certified Coding Associate (CCA)
• Outpatient Coding Specialist II & III: A minimum of one of the below certifications is required:
  • Certified Professional Coder Associate (CPC-S)
  • Certified Professional Coder (CPC)
  • Certified Coding Specialist (CCS)
  • Certified Coding Specialist – Physician (CCS-P)
  • Certified Coding Specialist – Hospital (CCS-H)
  • Registered Health Information Technician (RHIT)
  • Registered Health Information Administrator (RHIA)

Additional Requirements

• May be required to work outside the traditional work schedule