Coder II

MaineGeneral Health•Waterville, ME

5d•Onsite

About The Position

Assigns diagnosis and procedure codes to ensure quality documentation and accurate reimbursement for services provided. Assists with reconciling patient lists/census/discharge reports to track complete and accurate documentation/charges are obtained for each service rendered. Abstracts key non coding elements necessary for accurate billing (example: surgeon, surgical episode, discharge disposition) and manages worklists of incorrect claims and corrects to further support accurate billing. Reports back to providers and/or administrators regarding missing information. Reviews complex visit documentation from outpatient and/or ancillary areas to identify appropriate diagnostic and procedural codes (examples: ED, Cancer Center, Outpatient Surgery, Observation, Infusion). Uses coding guidelines and clinics to assign and sequence appropriate codes for 3-5 outpatient and/or ancillary patient areas in clinical information systems, including the assignment of appropriate modifiers as necessary. Queries practitioners as necessary to clarify. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.

Requirements

Proficiency in assigning diagnosis and procedure codes.
Ability to abstract key non-coding elements for billing.
Experience managing worklists and correcting claims.
Skill in reviewing complex visit documentation.
Knowledge of coding guidelines and clinics.
Experience assigning appropriate modifiers.
Ability to query practitioners for clarification.
Strong communication skills to seek clarification from healthcare providers.

Responsibilities

Reconcile patient lists/census/discharge reports to track complete and accurate documentation/charges.
Abstract key non-coding elements for accurate billing (e.g., surgeon, surgical episode, discharge disposition).
Manage worklists of incorrect claims and correct them for accurate billing.
Report missing information to providers and/or administrators.
Review complex visit documentation from outpatient and/or ancillary areas to identify appropriate diagnostic and procedural codes.
Assign and sequence appropriate codes for 3-5 outpatient and/or ancillary patient areas in clinical information systems.
Assign appropriate modifiers as necessary.
Query practitioners as necessary to clarify coding information.
Seek clarification from healthcare providers or other designated resources for accurate and complete coding.