Hospital Outpatient Coder V - Surgery Observation (1.0 - WFH)

Franciscan Alliance, Inc.

4d•Remote

About The Position

The Hospital Outpatient Coder V reviews electronic medical record documentation, and applies ICD and CPT codes, per Official Coding Guidelines, with a specific focus on hospital surgery, observation and monthly series services. This position abstracts key data elements necessary for billing and data analysis. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

Requirements

High School Diploma/GED - Required
2 years Coding - Required
Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required
Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) within 180days - Required
Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) within 180 days - Required

Nice To Haves

Associate's Degree in Health Information Management - Preferred
Bachelor's Degree in Health Information Management - Preferred
Surgery Coding experience - Preferred

Responsibilities

Accurately reviews and codes patient records in the following clinical areas: hospitalist rounds and office visits (with repetitive or non-invasive procedures).
Reviews and analyzes the content of the medical record to determine when documentation should be utilized for appropriate assignment of ICD diagnosis codes, CPT repetitive or non-invasive procedure codes, modifiers, hierarchical condition categories, complications, and comorbidities to meet coding guidelines.
Evaluates appropriateness of diagnosis and procedure codes and modifiers utilized in response to Outpatient Code Editor and National Correct Coding Initiative edits.
Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses.
Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and take steps to obtain the documentation.
Identifies and enters data elements for abstracting.
Meets defined coding accuracy standards.
Meets defined coding productivity standards.
Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.
Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing.
Remains current with coding and industry changes through participation in educational opportunities.
Demonstrates a thorough knowledge of professional coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines.
Notifies coding leadership of trends and topics for education and feedback to physicians and departments.
Assists with identification and implementation of process improvements, according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.