HIM Coder - Certified (Remote)

Clarke County Hospital•Osceola, IA

2d•Remote

About The Position

The HIM Coder reviews, codes, and abstracts outpatient hospital charges and verifies charges entered into the hospital computer system. The role also verifies deficiencies in outpatient, clinic, emergency room, and inpatient records, ensuring documentation and supporting reports are complete and that testing orders contain the required details and practitioner signature before coding. The position assists with HIM work queues involving coding issues, claim edits, and deficiencies; follows official coding and reporting guidelines and applicable Medicare and Title XIX coverage decisions; and reviews charges and documentation for accurate charge capture, billing compliance, and medical-record completeness. It also supports department overflow and backup coding coverage. The HIM Coder responds professionally to incoming calls and contributes to department and hospital goals, meetings, in-services, team decisions, customer satisfaction, and continuous quality improvement. The employee must follow hospital policies, safety guidelines, and applicable regulatory and compliance requirements, maintain required certifications, and complete annual education and competency requirements.

Requirements

Maintain current licenses and/or certifications required for the position.
Meet department business needs through regular, reliable attendance.
Complete annual education and competency requirements within the calendar year.
Apply knowledge of HIPAA, DIA, DNV, OSHA, and other applicable federal and state regulatory requirements.
Understand hospital and department compliance requirements for federally funded healthcare programs, including Medicare and Medicaid.

Responsibilities

Review, code, and abstract outpatient charges for hospital records using an encoder or ICD-10-CM, CPT-4, and HCPCS references, and enter them into the hospital computer system.
Verify all charges entered on an account.
Perform deficiency verification for outpatient, clinic, emergency room, and inpatient records, checking for pertinent and complete documentation and supporting reports.
Verify testing orders include the order date, testing ordered and completed, diagnosis, and practitioner signature before coding.
Assist with HIM work queues for coding issues, claim edits, and deficiencies.
Follow official ICD-10-CM, CPT-4, and HCPCS coding and reporting guidelines.
Follow Local and National Coverage Decisions distributed by Medicare and/or Title XIX.
Ensure medical-record documentation is complete and accurate according to accrediting and regulatory requirements.
Analyze and review charges and documentation for accurate charge capture and billing compliance.
Abstract data accurately, including disposition codes, date of service, place of service, and service type.
Assist with department overflow and provide backup coverage for other coders.
Answer incoming calls courteously and professionally, following Standards of Behavior.
Participate in completion of department and hospital goals, mandatory in-services, department meetings, and other applicable in-services.
Participate in team-oriented decision-making and remain flexible and open to others’ ideas.
Focus daily work on high customer satisfaction and meeting or exceeding customer expectations.
Identify improvement opportunities, communicate ideas to supervisors and/or staff, and carry out continuous quality improvement changes to work habits.
Follow hospital and department policies, procedures, safety guidelines, and Standards of Behavior.
Maintain regular, reliable attendance to meet department business needs.
Maintain required licenses and/or certifications and pursue professional growth through directed educational in-services.
Apply knowledge of HIPAA, DIA, DNV, OSHA, and other applicable federal and state healthcare regulations.
Complete annual education and competency requirements within the calendar year.
Follow compliance requirements for federally funded healthcare programs, including Medicare and Medicaid, and promptly raise compliance concerns with hospital administrative staff.