Coder II

OhioHealth•WORK AT HOME - OHIO, OH

3d•Remote

About The Position

This position performs facility coding and abstracting functions of outpatient cases including Emergency Department, Diagnostics, MSF and Recurring Patient type, Ambulatory Surgery, Observation, Outpatient in a Bed, and/or Clinic charging and coding of accounts.

Requirements

High School or GED (Required)
AAPC - American Academy of Professional Coders - AAPC American Academy of Professional Coders
AHIMA - American Health Information Management Association - American Health Information Management Association
RHIA - Registered Health Information Administrator - American Health Information Management Association
RHIT - Registered Health Information Technician - American Health Information Management Association
Completion of a 2 year program and coding Certification from AHIMA or AAPC and/or graduate of a HIM program and Certification as RHIA/RHIT
Demonstrated knowledge of ICD-9, ICD-10 and CPT-4 classification systems
Advanced Anatomy & Physiology
Medical Terminology
Ambulatory reimbursement schemes
CMS Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) guidelines.
Must be eligible to sit for Certification exam within 6 months of hire or within 6 months of completion of the coding program, and pass the AAPC and/or AHIMA Certification exam.

Responsibilities

Assigns appropriate admit, reason for visit, principal and secondary ICD-9, ICD-10 and CPT- 4 diagnoses and/or procedures by reading documentation present in medical record and applying knowledge of correct coding guidelines as appropriate for hospital service and/or patient type while maintaining 95% quality and meeting and maintaining the minimum Coder productivity requirements.
Assigns appropriate CPT Modifiers for facility coding to all CPT codes when necessary.
Reviews records for diagnoses that meet medical necessity for Diagnostic and surgical procedures performed according to the CMS Local Coverage Determination LC d and/or National Coverage Determination NC d guidelines.
Responsible for recognizing when it is necessary to obtain further clarification from physician when documentation is inadequate, ambiguous, or unclear for coding purposes.
Responsible for accurate coding and charging of clinic accounts including the assignment of a facility E/M level using the Ohio Health Scorecard for guidance.
Responsible for retrieval of documentation to support the coding of accounts that reside in non-HIM department source systems GE Gentricity, Mosaic, etc.
Assists educators and supervisors with reviewing accounts denied by RAC and other governmental payers for appropriate documentation to support original coding.
In the event of insufficient, missing or conflicting documentation, assigns transaction codes in HBOC system and follows department policy for follow up and physician query.
Abstracts all data elements necessary to complete UB0 4 and meet hospital-reporting requirements.
Verifies demographics, corrects account number, charges and service and identify missing or incorrect forms in each record.
Identifies problem cases on the DNFB and forwards to appropriate staff for follow up.