Coder 3

Fairview Health Services•St. Paul, MN

About The Position

Fairview is hiring a Coder 3 for its Coding team. This is a 1.0 FTE (80 hours every two weeks), benefit-eligible clinical or hospital-based coding position focused on specialty professional or hospital outpatient accounts. The schedule is primarily during standard business hours, with the potential for occasional weekend hours. The role offers a flexible work environment, independent work, and collaboration with coding professionals and other departments across the organization. The OP Coder 3 assigns ICD-10-CM, CPT-4, and HCPCS codes to complex outpatient accounts for billing, internal and external reporting, research, and regulatory compliance. The coder uses an encoder and/or computer-assisted coding (CAC) software, assigns APC weights, resolves medical necessity edits, and extracts data for the medical record abstract. The position requires analysis of clinical documentation, research into complex coding scenarios, and abstraction of codes and other clinical data used for reimbursement, quality assessment, healthcare data analysis, and regulatory and payer reporting. The ideal candidate has strong CPT surgical coding experience and a solid understanding of anatomy, disease processes, and medical terminology. Experience with complex surgical procedures, coding software, and electronic health records is highly preferred.

Requirements

Completion of an accredited coding certificate program or a Health Information Technician program.
At least 2 years of coding experience.
One of the following credentials: RHIA, RHIT, CCS, CPC, CCS-P, CPC-H, COC, or AAPC specialty certification.
Strong experience in CPT surgical coding.
Solid understanding of anatomy, disease processes, and medical terminology.
Ability to accurately interpret complex medical documentation, apply coding guidelines, and ensure coding accuracy and compliance.

Nice To Haves

Associate of Science in Health Information.
Bachelor of Science in Health Information.
Two years of coding experience with a variety of professional and hospital accounts, such as observation, surgical outpatient, interventional radiology, heart catheterization, or professional surgical specialty billing.
Experience with complex surgical procedures, coding software, and electronic health records.

Responsibilities

Maintain knowledge of and comply with relevant laws, regulations, policies, procedures, and standards.
Participate in creating and implementing workflow improvements.
Assign ICD-10-CM, CPT-4, or HCPCS codes to diagnoses, treatments, and procedures for complex hospital outpatient or clinical department visits.
Apply knowledge of the relationship between disease management, medications, ancillary test results, and assigned diagnoses.
Research and understand simple and moderately complex coding issues.
Use coding software proficiently and troubleshoot simple computer issues.
Apply technical coding principles and/or APC reimbursement expertise to assign ICD-10-CM diagnoses and CPT-4 procedures, including CPT modifiers.
Extract required information from the electronic medical record and enter it into coding software and the abstracting system.
Identify chargeable items for department visits and enter them into the computer system, if applicable.
Follow up on unabstracted accounts to support timely billing and reimbursement.
Research and communicate to resolve questions concerning diagnoses, procedures, clinical chart content, or code selection.
Query physicians about documentation according to established procedures and guidelines, when appropriate.
Meet productivity and quality standards established by coding managers.
Educate multidisciplinary team members, including physicians, about changing mandated rules, regulations, and guidelines to support compliant claims.
Identify and resolve clinical documentation and charge capture discrepancies to improve documentation quality, reimbursement complexity accuracy, and reported data integrity.
Complete work accurately and on time, and contribute to collecting expected payment.
Understand and adhere to Revenue Cycle’s Escalation Policy.
Adjust service approaches to reflect the developmental level and cultural differences of the population served.
Partner with patients and caregivers in care and decision-making, communicate respectfully, and help ensure a safe and secure environment.
Individualize care plans and modify clinical interventions based on the population served; provide patient education based on assessed learning needs.
Complete role-relevant required learning and foster a culture of improvement, efficiency, and innovative thinking.
Perform other responsibilities and duties as assigned.