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.
Under the general direction of the OP Coding Supervisor, the Outpatient Coder 2 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in two complex outpatient coding service line. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks , resolving claim edits, handling individual coding workload, working stop bills (if assigned), and sending queries, as needed, to clinical staff.
Responsibilities: 1. Reviews medical record documentation to determine appropriate ICD-10-CM codes in accordance with official coding guidelines. 2. Reviews medical record documentation and accurately selects the appropriate CPT codes, modifiers, and ICD-10-PCS, when applicable, in accordance with official coding guidelines. This includes resolving CCI edits, as applicable. 3. Maintains a minimum of 95% overall coding quality score in diagnostic, procedural, and modifier code selection in a two (2) complex OP coding service lines. 4. Maintains the productivity expectations as defined by the department for the OP coding service lines. 5. Capable of coding a minimum of two (2) complex OP service line, which would include: Cardiology, Interventional Radiology, Observation, Oncology, or Same Day Surgery at proficiency. 6. Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions, and actively participates in learning circles. 7. Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet CFB (candidate for billing) goals. 8. Prioritizes coding workload appropriately by focusing efforts on cases and service lines with the potential to impact department goals. 9. Resolves cases returned coder for education and/or errors, and uses feed back to improve ongoing performance. 10. Handles coding DNBs and stop bills, if assigned, or other projects and/or coding initiatives as assigned. 11. Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures. 12. Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and vision of the department.
Bachelors degree preferred. Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process
Requires a minimum of three (3) years of outpatient or professional coding experience in complex types of coding. Up to two years of coding experience may be substituted for a college degree with an RHIT credential or a CCS/CCS-P coding credential. Prior experience in Epic and 3M encoder preferred.
CCS, CCS-P, or RHIT credential preferred. Must possess a valid coding credential through AAPC and/or AHIMA. Coding credentials specific to areas of expertise preferred. CCA or CPC-A not accepted.
Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM/PCS, and CPT coding with the ability to acclimate and apply knowledge in a fast-paced OP coding department setting. Knowledge of professional E/M leveling preferred. Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills. Must be able to perform functions independently and under limited supervision.
Must meet the defined accuracy and productivity standards in two complex service lines. Must be able to manage individual workload, prioritize work effectively to meet the demands of the department, and follow all coding workflows in place independently with minimal guidance and as part of a team. Adheres to Yale New Haven Health Standards of Professional Behavior : Patient-Centered Care, Respect, Compassion, Integrity, and Accountability.
Exercises independent judgment in determining appropriate diagnostic and procedure data from all types of medical record documentation and in contacting physicians. Must be able to complete assignments with attention to detail and high degree of accuracy.