Outpatient Coder 1

New Haven, CT
Mar 1, 2019

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Job Description

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

EEO/AA/Disability/Veteran

Summary:
Performs a variety of coding activities involving charging and billing of simple records including but not limited to ED to Admits, GI, Bronchoscopy, office visits and ancillary as a mechanism for indexing medical information used for statistics for hospital, regional, and government planning, accurate hospital reimbursement, research, utilization and appropriateness of care. Work may include coding for more complex procedures.

Responsibilities:
  • 1. Analyzes and codes patient encounters in a timely and accurate manner to ensure quality data and timely billing.
  • 1.1. Completes assigned work ensuring department benchmarks are met or exceeded consistently in accordance with current industry standards and use of current technologies.
  • 1.2. Ensures all available records are coded to meet OP coding minimum days/CFB.
  • 1.3. Monitors and works "Bill Edit Report" on a daily basis in order to maintain the departmental goal.
  • 1.4. Analyzes and assigns all YNHHS codes and diagnoses in accordance with national coding and departmental guidelines.
  • 1.5. Assigns ICD-10 and CPT codes and ensures consistency between procedures charged for, using the charge master and clinical evidence within the documentation achieving an accuracy rate of 95% or greater.
  • 1.6. Assigns appropriate tier levels, associated procedures, injections/infusion administration and ancillary charges in the system for encounters with an accuracy rate of 95% or greater.
  • 1.7. Reviews and analyzes any initial coding edits, such as CCI/OCE.
  • 2. Maintains professional skills and remains engaged in the goals and vision of the organization to ensure the department functions efficiently and accurately with integrity.
  • 2.1. Actively participates in staff meetings and offers constructive suggestions for improving the process.
  • 2.2. Identifies and reports all procedures and findings that are not accurate.
  • 2.3. Reviews all memos, emails and policy updates as they are distributed to ensure current coding and billing procedures are followed.
  • 2.4. Participates in career development activities by utilizing American Coding School, reading journals and coding articles and attending coding educational in-services and webinars.
  • 2.5. Complies with all aspects of the telecommuting agreement and participates in all mandatory training and/or staff meetings. Reports to work on-site as requested.
  • 2.6. During periods of heavy workload, will provide assistance to other work areas as needed and will exercise good judgment and demonstrate flexibility.
  • 2.7. Maintains skills with ICD-10-CM, ICD-10-PCS and CPT-4 through the use of Coding Books and/or utilizes Encoder/CAC to ensure current resources are referenced to assure accurate and up-to-date code assignments.
  • 2.8. Assists in cross training of staff as needed and requested by coding leadership.
  • 2.9. Reviews and responds to quality and compliance audits within the required response period using the assigned documentation format.

    Other information:

    EDUCATION:

    High school graduate with additional training in ICD-10, CPT-4, and E&M Coding. Certified Coding Specialist (CCS), Physician-based (CCS-P) certification through the American Health Information Management Association (AHIMA) and/or Certified Professional Coder (CPC) through American Academy of Professional Coders (AAPC) is required.

    EXPERIENCE:

    Minimum of one (1) year experience with some understanding of hospital reimbursement, ICD-10, CPT-4, and E&M classification systems. Knowledge of YNHHS computerized encoder systems.

    LICENSURE:

    Certified Coder: CPC, COC, CCS or other applicable coding certification through the AAPC and/or AHIMA required.

    SPECIAL_SKILLS:

    Knowledge of anatomy/physiology, medical terminology, ICD-10 CM and PCS, and CPT coding. Knowledge of E&M professional coding. Good communication skills, ability to exercise good judgment, independent logic, and excellent computer data entry skills.
    ACCOUNTABILITY:

    Accurate coding and charging for services with a minimum of 95% accuracy rate.
    COMPLEXITY:

    Exercises independent judgment in determining appropriate diagnostic and procedure data and charges. Takes responsibility for the coding workflow.
    PHYSICAL_DEMAND:

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    Job Info

    Job: 6418

    Department: HIM Coding
    Category: Him/med Records
    Status: Full Time
    Shift: DAYS
    Hours: 40.00