Coder

City of Hope

About The Position

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today. This role is responsible for following established procedures for the review, classification, and abstraction of clinical data from patients’ medical records regarding diseases, treatment given, and operative procedures for assignment of diagnostic and procedural codes and modifiers. This role abstracts and codes relevant data elements for a certain type of professional fee service area (i.e., Evaluation & Management, major and minor surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges) for multi-specialty physicians.

Requirements

Post High School or equivalent.
Two years of coding experience of professional fees (physician/medical office).
Thorough knowledge of medical terminology/anatomy/ physiology.
Comprehensive understanding of professional fee coding principles, including knowledge and proper application of assigning ICD and CPT codes, bundling, and modifiers based on regulatory guidelines.
Current knowledge, training and experience in ICD-10.
CPC, CCS-P, or CCS.

Responsibilities

Reads and interprets medical record documentation to identify all diagnosis, conditions, problems and procedures for Evaluation & Management, surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges.
Clarifies conflicting, ambiguous, or non- specific information appearing in a medical record by consulting the appropriate physician.
Applies Official ICD-10-CM Guidelines to select first-listed diagnosis, primary procedure, complications, co-morbid conditions, other diagnoses and significant procedures which require coding.
Applies knowledge of ICD-10-CM and CPT-4 instructional notations and conventions to locate and assign the correct diagnostic and procedural codes and sequence them correctly.
Applies knowledge of current approved ICD-10-CM and CPT-4 coding guidelines to assign and sequence the correct diagnoses and procedure codes.
Applies knowledge of anatomy, clinical disease processes, and diagnostic and procedural terminology to assign accurate codes to diagnoses and procedures.
Applies the Basic Coding Guidelines for professional fee physician coding to select and sequence diagnoses, conditions, problems, or other reasons which require coding for professional fee charges.
Applies knowledge of CPT-4 coding guidelines and notes to locate the correct codes for all services and procedures performed during the encounter and sequence them correctly.
Applies knowledge of government and commercial payer reimbursement guidelines to ensure optimal reimbursement.
Ability to utilize computerized encoder/grouper as a reference tool for coding.
Keeps current with ICD-10-CM and CPT-4 code changes, coding guidelines, and coding updates.
Assist with charge corrections as identified when coding professional fee services.
Reviews and completes required reporting documents as required by external and internal systems.
Completes productivity reports and submits them to the manager, supervisor, or lead.
Consistently meets coding quality standards and thresholds.
Attends meetings as required.
Successfully completes required education courses to maintain current coding certification.