Facility Coder - Certified

Confluence Health•Wenatchee, WA

1d•Remote

About The Position

The Certified Facility Coder reviews medical records, extracts information, and assigns diagnosis and procedure codes for billing, internal and external reporting, research, and regulatory compliance. The role codes conditions and procedures according to the Official Guidelines for Coding and Reporting and ensures coding practices comply with ICD-10-CM/PCS, CPT, and HCPCS guidelines from the AMA and CMS. Codes are assigned using an electronic encoder in accordance with organizational policy and regulatory requirements. This position may be performed virtually, but the employee must reside in Washington, Oregon, Idaho, Wisconsin, Florida, Montana, Texas, Arizona, Virginia, or Tennessee. The position reports to the Coding Department Supervisor.

Requirements

High school diploma or equivalent GED.
At least 1 year of coding experience or equivalent education/experience.
Knowledge of ICD-10 and CPT coding, medical terminology, anatomy, and insurance billing.
Understanding of DRGs for inpatient facility coding positions.
Basic computer skills, including spreadsheets and word processing.
One of the following certifications: CPC or CPC-A, CIC, or COC or COC-A from AAPC; or CCA, CCS, CCS-P, RHIA, or RHIT from AHIMA.

Nice To Haves

Experience with EPIC EHR.
Experience with the Nuance Clintegrity encoder system.
A second coding certification from AAPC or AHIMA.

Responsibilities

Code inpatient, ambulatory, observation, and emergency department records, including charge capture and medication administration charges, and code across multiple specialties and procedures.
Code Interventional Radiology, Radiology, outpatient obstetrics, outpatient therapy, and/or infusions.
Extract and assign ICD-10-CM/PCS, CPT, modifier, and HCPCS codes using an electronic encoder and following coding guidelines, hospital policy, and regulatory requirements.
Code inpatient diagnoses and procedures according to UHDDS definitions and the Official Guidelines for Coding and Reporting.
Understand and assign DRGs, MCs, and CCs for inpatient facility coding.
Review accounts and charges in EPIC and review and adjust coding for Part A/B rebilling.
Research Coding Clinics and review medications to apply appropriate infusion administration charges.
Assist with payer and RAC coding audits, including providing rebuttal letters when needed.
Code records based on documentation while following coding guidelines, payer regulations, and ethics.
Apply CMS HCC risk-adjustment coding knowledge and resolve CCI/LCD/NCD and modifier edits.
Use software and/or coding books to verify coding accuracy and stay current with billing guidelines and reimbursement rules and regulations.
Work with Revenue Integrity and Compliance on audits and coding questions, and collaborate with Clinical Documentation Specialists.
Provide provider feedback using authorized methods, including queries for incomplete or contradictory diagnoses or greater specificity.
Work with clinical staff to resolve coding issues and related problems, and participate in educational activities as requested.
Meet department coding production standards for assigned specialties.
Perform other duties as assigned or requested to support the organization and adhere to standards of behavior and the Code of Conduct.