HIM Outpatient Surgery/Ambulatory Coder - OBGYN

The University of Kansas Health System

120d

About The Position

The HIM Outpatient Surgery/Ambulatory Coder is responsible for reviewing outpatient/inpatient EHR. This position monitors CPT, ICD-10, and HCPCS code changes. Audits and/or assigns codes (CPT, HCPCS, and diagnosis) for professional and hospital accounts for Primary Care/Medical Specialty/Simple Procedural services from clinical documentation for accurate professional billing and facility APC assignment. The HIM Outpatient Surgery/Ambulatory Coder is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to ensure appropriate physician and facility coding and billing.

Requirements

• High School Graduate or GED.
• Coding accuracy: 95% or better in accordance with HIM Quality Analysis Policy.

Nice To Haves

• Associates Degree in Health Information Management or a related field of study from an accredited college or university.
• 1 or more years of experience in Epic.
• 1 or more years of experience in billing and/or data entry in a health care facility or physician office.
• 2 or more years of coding experience in inpatient and/or outpatient ICD-10 CM/PCS.

Responsibilities

• Reviews outpatient/inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing.
• Reviews departmental reporting structures and requests modifications as needed, i.e. adding billing areas, providers, etc.
• Monitors CPT, ICD-10, and HCPCS code changes.
• Audits and/or assigns professional and hospital codes and modifiers (CPT, HCPCS, and diagnosis) for Primary Care/Medical Specialty/Simple-Surgical accounts using ICD-10 nomenclature.
• After completion of two years of coding may train on specialty/complex surgical coding.
• Reviews coding by physicians and suggest possible modification of codes to maximize reimbursement as allowed by coding and payer guidelines in accordance with supporting documentation.
• Reviews reimbursement policy from payers to ensure payment through proper use of codes and modifiers.
• Identifies and resolves potentially troublesome service/billing areas such as continuity of care, discharge summaries, admission history and physicals and consultations.
• Resolves professional and hospital coding related edits and denied claims for outpatient surgical and ambulatory services.
• Communicates pertinent information on appropriate documentation to physicians and staff.
• Maintains knowledge of requirements for appropriate charge generation.
• Identifies and codes for all diagnoses documented supported within clinical documentation.
• Captures unspecified diagnoses used and determine if documentation supports a more specific diagnosis.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT coding guidelines to inpatient and outpatient diagnoses and procedures.
• Consults with and educates/trains physicians on coding practices and conventions in order to provide detailed coding information.
• Communicates with nursing and ancillary services personnel for needed documentation for accurate coding.
• Provides real-time feedback to providers as it pertains to proper coding and clinical documentation of services performed.
• Must be able to meet productivity requirements as outlined by clinical specialty and hospital quality requirements of 95% or better after training has concluded.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED