The Hospital Outpatient/Lab Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using International Classification of Diseases Clinical Modification (ICD-10-CM) at an entry level of complexity for outpatient/lab services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, drugs and biologicals, revenue codes, ICD-10 CM (Clinical Modification) and CPT codes, medical terminology, anatomy and physiology, and pharmacology, as well as ensures claims meet medical necessity for procedures performed. Essential Functions Reviews and analyzes outpatient/lab records for completeness, accuracy and compliance. Performs coding at an entry level of complexity for hospital outpatient/lab type accounts in the acute care hospitals including governmental and/or payer specific requirements. Following regulatory guidelines, assigns appropriate diagnosis and procedure codes using ICD-10-CM. Ensures that coded data accurately reflects the complexity of the services provided and quality of care. Validates Ambulatory Payment Classification (APC) assignments and reimbursement calculations. Abides by the American Health Information Management Association (AHIMA) Code of Ethics and Standards of Ethical Coding. Follows coding policies and procedures and reports any issues or discrepancies. Responds promptly to inquiries from revenue services related to the use of codes and modifiers within the billing process to assure accuracy and avoid delays in the billing process. Identify charge issues/opportunities. Works with departments to make recommendations, resolve issues and enhance charge capture and compliant data. Verifies data abstracted and entered from the electronic health record Ensures compliance and accurate submission of publicly reported data for all payers. Skills ICD-10-CM PCS Electronic Health Record Anatomy, physiology & pathophysiology Accuracy Detail oriented Coding software Computer literacy Coding regulations Analytical Skills Required Qualifications High School Diploma or GED required. Demonstrates strong knowledge and understanding of medical terminology, medical acronyms, pharmacology, anatomy and physiology and ICD-10-CM/PCS, DRG, and APR-DRG classification systems. Ability to complete and pass internal coding exam. Demonstrated proficiency in using coding software, electronic health records, and other health information systems. Demonstrated excellent communication, interpersonal, and analytical skills Ability to work independently and collaboratively in a fast-paced environment Preferred Qualifications Associate degree or higher in health information management, health informatics, or related field. Degree must be obtained through an accredited institution. Education is verified. Demonstrated acute care facility coding experience which includes both ICD-10-CM & PCS coding with multidisciplinary service lines. Experience with EPIC EHR and 3M 360 CAC (Computer Assisted Coding), using 3M automation tools. Physical Requirements Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. May have the same physical requirements as those of clinical or patient care jobs when the leader takes clinical shifts. For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles. Thanks for your interest in continuing your career with our team!
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED