Coder III - Outpatient

Avera•Sioux Falls, SD

1d•$25 - $38

About The Position

Responsible for the timely and accurate assignment of diagnostic and procedural codes for most types of outpatient charts for multiple facilities within Avera Health, with a focus on the more complex and high-dollar cases. Accurate abstracting along with other reporting and editing function is also a major responsibility. The Coder III works independently to meet quality and production goals for the position. Varied amounts of time will be spent educating Coder I, III and III coders along with helping others with denials management.

Requirements

The individual must be able to work the hours specified.
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) within 180 Days or Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) within 180 Days or Registered Health Information Tech (RHIT) - American Health Information Management Association (AHIMA) within 180 Days or Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Association (AHIMA) within 180 Days

Nice To Haves

Associate's Health Information Administration or Health Information Technology
4-6 years of coding experience

Responsibilities

Review all aspects of a patient's clinical documentation in order to identify the appropriate sequence of ICD-10-CM, CPT, and HCPCS diagnosis and procedure codes for assigned patient charts across Avera's facilities.
Understand ICD-10-CM, CPT and HCPC codes in depth, and be willing to update that knowledge through research or other educational opportunities.
Focus on determining the appropriate APC/EAPC and/or appropriate medical coding for a variety of outpatient patient types including, but not limited to, surgeries, observation, injections/infusions, and/or oncology.
Expected to have a mastery of the majority of all outpatient types in the outpatient service line and code those as needed.
Serve as a subject matter expert for other health professionals within Avera on coding related topics.
Queries physicians and clinical documentation staff to ensure a full capture of the clinical record.
Assist staff with denials management, including the processing of edits, serving as a subject matter expert, or helping to provide input for medical necessity and other related appeals using appropriate coding guideline references.
Lead communication between health information management, billing, and providers as needed.
Maintains personal quality and production statistics in accordance to service line standards for a Coder I.
Adheres to ethical standards regarding coding as set by Avera Health.