Coder Specialist

Ochsner Clinic Foundation•New Orleans, LA

About The Position

The Coder Specialist reviews and accurately codes professional services, including evaluation and management services and procedures, or hospital outpatient surgeries and procedures and observation patients. The role follows applicable Medicare, Medicaid, and third-party payer guidelines to support accurate reimbursement. It validates that medical documentation supports assigned codes, maintains data integrity, and meets established department productivity and accuracy standards. Coding may include professional surgical coding and hospital outpatient and observation coding.

Requirements

High school diploma or equivalent.
At least 1 year of coding experience.
Computer skills and dexterity for data entry and retrieval of patient information.
Effective verbal and written communication skills, including the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
Proficiency with Windows-style applications, software packages specific to the role, and keyboard use.
Knowledge of ICD-9-CM, ICD-10, CPT, HCPCS, and coding principles.
Excellent decision-making, problem-solving, analytical, and quality management skills.

Nice To Haves

Completion of an accredited AHIMA or AAPC coding program with certification.
Recognized certification by AHIMA or AAPC.

Responsibilities

Assign ICD-10, CPT, and/or HCPCS codes accurately and in accordance with established coding guidelines, rules, and regulations.
Review medical documentation and verify that it sufficiently supports assigned codes and the integrity of coded patient records.
Research patient accounts in response to questions and/or errors.
Meet established department productivity and accuracy standards.
Communicate with providers to request clarification or additional documentation as needed.
Collaborate with team members and other departments to meet monthly departmental goals, which may include DNFB, Pre-AR, denials, and claim edits.
Verify correct discharge disposition when appropriate based on medical documentation.
Remain knowledgeable about and comply with applicable laws, accreditation standards, and regulatory requirements.
Report known or suspected unethical or questionable conduct and patient/employee safety, privacy, or other compliance-related concerns.
Perform other related duties as required.