Certified Surgical Coder

Nebraska Methodist Hospital•Omaha, NE

18h•Onsite

About The Position

The Certified Surgical Coder codes professional charges for surgical procedures for inpatient and outpatient services, including appropriate CPT and ICD-10-CM codes and modifiers, in accordance with medical policies and guidelines. The role assigns and enters diagnosis and procedure codes, reviews charges for services and devices, supports accurate billing and reimbursement, and investigates claim denials. The position is based at the Methodist Corporate Office in Omaha, Nebraska, and follows a Monday–Friday schedule with flexible eight-hour daytime shifts. Nebraska Methodist Health System describes its culture as focused on exceptional care for the communities it serves and the people it employs. The organization offers competitive pay, benefits, and a work environment where employees are valued and contribute to their communities.

Requirements

High school diploma or GED.
Completion of college-level courses in anatomy and physiology, biology, disease process, and medical terminology.
At least one of the following credentials: CPC, COC, RHIT, CCA, or CCS-P.
Ability to review medical records closely, verify diagnoses, and review charges when assigning ICD-10-CM and CPT codes.
Understanding of outpatient prospective payment methodology and national correct coding initiatives.
Ability to operate a personal computer and Microsoft Office programs, including Word and Excel.
Ability to perform the role’s stated light-work physical demands, including exerting up to 20 pounds of force.

Nice To Haves

Associate’s degree in Health Information Management or a healthcare-related field.
Three or more years of previous experience coding physician services from documentation; surgical and Evaluation/Management coding experience is required.

Responsibilities

Assign ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS device codes to outpatient records using applicable coding principles and UHDDS definitions, targeting an accuracy rate of at least 95%.
Enter diagnosis and procedure codes into the code summary to support disease and operation indexing and timely, correctly coded claims; maintain at least 95% accuracy.
Review CPT and HCPCS codes in the code summary and charge viewer, review CCI edits, attach modifiers, and add or modify charges to ensure accounts reflect services and devices provided and appropriate reimbursement.
Review hospital billing charges and services with physicians, answer questions, and advise on insurance billing updates.
Review coding with physicians as requested and in accordance with departmental audit standards.
Investigate third-party payer claim denials by reviewing services and patient accounts and making coding or charge corrections according to department processes and requests.
Maintain outpatient accounts receivable within three days of discharge to support timely claim submission.
Meet the stated hourly productivity standards for OPS, OBS, Infusion Center, GI/Pain Management, Radiology/OP Diagnostic Services, recurring encounters, non-patient pathology, Emergency Department, and Professional Services.
Use the charge viewer and make appropriate changes to support accurate charges and maximum reimbursement.
Participate in mandatory in-services and continuing education as required by policy, external agencies, and the supervisor.