Coder Physician

Omega Healthcare Management Services•Boca Raton, FL

About The Position

Experienced pro fee coder with a minimum of 5 years of experience in coding for an academic trauma level 1 facility: -Surgical Pathology -ENT (outpatient office services, including E/M and in-office procedures) -Dermatology (outpatient office services, including E/M and in-office procedures) -Pain (strong outpatient E/M & procedure coding experience) Epic experience required. A CCS, CCS-P or CPC coding credential required. Schedule is M-F 8 hours day. Shift times are flexible withing reason. MUST BE AVAILABLE DURING REGULAR BUSINESS HOURS PST FOR TRAINING THE FIRST WEEK. 6 month assignment with the option to extend. JOB SUMMARY Under general supervision the incumbent independently performs coding of patient’s records to provide accurate physician, technical, supply, surgical and resident billing, and reimbursement, while ensuring compliance. The incumbent’s work is performed in the centralized clinic coding unit setting, which will include two or more of the following: professional fees, technical fees, multi-specialties, surgical, and/or resident staff coding and billing. Prior to submitting charges, the incumbent is required to review documentation for all patient visits and procedures, identify all billable services, and discuss with the provider when discrepancies occur in documentation. Codes and enters charges in the online charge entry system. Responsible for working workques and charge reconciliation. This position must have knowledge of the following system applications: Mainframe, EMR, EPIC Charge Capture, Word, Excel, Internet Explorer, Images, CITRIX, Quantim, Microsoft Outlook, HIPAA Disclosures, and Incident Reporting. Key Responsibilities - Total percent of time must equal 100% % TIME Function Duties 80% REVIEW, ABSTRACT AND CODE OUTPATIENT RECORDS TO ENSURE DATA QUALITY AND TO OPTIMIZE REIMBURSEMENT A-1 Reviews outpatient record to abstract medical, surgical, laboratory, pharmacy, technical, service providers, demographic and social data from the medical record within established standards, including but not limited to, lag day policy and coding quality standards. A-2 Distinguish surgical procedures and follow up care performed by billable providers, residents, interns, and others. A-3 Ensures that all diagnoses and procedures that impact reimbursement are identified, sequenced correctly, and coded in an accurate and ethical manner for appropriate reimbursement. A-4 Researches and identifies correct codes for new procedures and/or diagnoses A-5 Assigns Evaluation and Management codes according to established standards utilizing coding guidelines. A-6 Responsible for processing APC charges using APC grouper. A-7 Applies professional and technical guidelines as appropriate. A-8 Consults with providers for clarification when conflicting or ambiguous and/or significant missing documentation information is identified. A-9 Assigns appropriate modifiers for both technical and professional coding. A-10 Applies State, Federal and internal UCDHS guidelines when coding. 15% CLINICAL CHARGE ENTRY B-1 Enters all charges into appropriate charge entry systems within established standards. 5% MISCELLANEOUS C-1 Maintains a clean and well-organized work area C-2 Performs other duties as assigned. C-3 Attend mandatory coder education/training sessions Other Other Requirements - Applies to all Positions Performs other duties as assigned This job description is not intended to be a complete list of all responsibilities, duties or skills required for the job and is subject to review and change at any time, in accordance with the needs of the organization Complies with all policies and standards Percentages of time allocated to functions are a guideline only. Individual assignments and time actually worked in each functional area may vary based on the department’s operational needs Ability to follow ICD-10, CPT and HCPCS guidelines related to assigning single, and sequencing multiple diagnosis and procedure codes for appropriate professional and technical reimbursement and for data collection. Ability to assign Evaluation and Management visit levels using the current guidelines. Comprehensive knowledge of medical diagnostic and procedural terminology. Knowledge of disease processes, anatomy and physiology, and medical terminology. Ability to communicate technical and clinical billing information to physicians and clinical staff. Ability to manage time schedules, deadlines, multiple requests, and priorities and to maintain productivity. Excellent written and oral communication skills. Abides by American Health Information Management Association’s established code of ethical principles to safeguard the public and contribute with the scope of this position to quality and efficiency in health care. Abides by all compliance principles regarding fraud and abuse in the reimbursement environments

Requirements

5+ years coding experience as listed above in an Academic Trauma facility
Epic Experience
Able to work M-F 8 hours a day
Able to pick up new workflows and technology easily
Able to ramp up productivity in 4 weeks
Maintain 95% accuracy in all coding
Good written and verbal communication
A CCS, CCS-P or CPC coding credential required
MUST BE AVAILABLE DURING REGULAR BUSINESS HOURS PST FOR TRAINING THE FIRST WEEK
Ability to follow ICD-10, CPT and HCPCS guidelines related to assigning single, and sequencing multiple diagnosis and procedure codes for appropriate professional and technical reimbursement and for data collection.
Ability to assign Evaluation and Management visit levels using the current guidelines.
Comprehensive knowledge of medical diagnostic and procedural terminology.
Knowledge of disease processes, anatomy and physiology, and medical terminology.
Ability to communicate technical and clinical billing information to physicians and clinical staff.
Ability to manage time schedules, deadlines, multiple requests, and priorities and to maintain productivity.
Excellent written and oral communication skills.
Abides by American Health Information Management Association’s established code of ethical principles to safeguard the public and contribute with the scope of this position to quality and efficiency in health care.
Abides by all compliance principles regarding fraud and abuse in the reimbursement environments

Responsibilities

Reviews outpatient record to abstract medical, surgical, laboratory, pharmacy, technical, service providers, demographic and social data from the medical record within established standards, including but not limited to, lag day policy and coding quality standards.
Distinguish surgical procedures and follow up care performed by billable providers, residents, interns, and others.
Ensures that all diagnoses and procedures that impact reimbursement are identified, sequenced correctly, and coded in an accurate and ethical manner for appropriate reimbursement.
Researches and identifies correct codes for new procedures and/or diagnoses
Assigns Evaluation and Management codes according to established standards utilizing coding guidelines.
Responsible for processing APC charges using APC grouper.
Applies professional and technical guidelines as appropriate.
Consults with providers for clarification when conflicting or ambiguous and/or significant missing documentation information is identified.
Assigns appropriate modifiers for both technical and professional coding.
Applies State, Federal and internal UCDHS guidelines when coding.
Enters all charges into appropriate charge entry systems within established standards.
Maintains a clean and well-organized work area
Performs other duties as assigned.
Attend mandatory coder education/training sessions