Facility Coding Outpatient Complex Coder

Banner Health•Mesa, AZ

1d•Remote

About The Position

This position provides coding and abstracting for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes the highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities. Reviews health record documentation and assigns diagnoses and/or surgical procedure codes on all outpatient complex records using ICD CM/PCS and CPT4 coding classification systems. Completes APC assignment on outpatient complex records as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and nationally recognized coding guidelines.

Requirements

2 years recent experience in Outpatient Facility-based coding of Same Day Surgery & Observation (clearly reflected in your attached resume)
Experienced in ICD-10-PCS & ICD-10-CM coding
Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. (Please upload a copy or provide certification number in your questionnaire.)
Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certificaion in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).
Requires two or more years of outpatient complex experience in an acute care inpatient facility or healthcare system.
Must demonstrate a level of knowledge and understanding of ICD CM/PCS, CPT4 coding principles and coding competencies as demonstrated by certification through the American Health Information Management Association or by the American Academy of Professional Coders.
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.

Nice To Haves

Associates degree in a job-related field or experience equivalent to same.
Previous experience in large, multi-system healthcare organization.
Additional related education and/or experience preferred.

Responsibilities

Analyzes medical information from medical records. Accurately codes diagnostic and procedural information, including modifiers, in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM/PCS and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
Abstracts clinical diagnoses, procedure codes and other pertinent information obtained from the patient encounter. Place account in the appropriate status for required missing documentation to complete assignment of disease and procedure codes, and any pertinent abstract elements.
Provides quality coding by ensuring compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as Banner specific policy and procedures and applicable professional standards for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities.
May provide mentoring for less experienced staff members. May act as a subject matter expert for complex coding.
Works under general supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address complex coding matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to coding analyst, coding educator, or coding manager/supervisor.