Hospital Outpatient Specialty Coder

Ovation Healthcare

1d•Remote

About The Position

Ovation Healthcare, formerly QHR Health, has been strengthening independent community healthcare for over 40 years. Their mission is to provide independent hospitals and health systems with support, guidance, and tech-enabled shared services to ensure their viability. They aim to be a dynamic, integrated professional services company delivering innovative solutions through experience and thought leadership, valuing trust, respect, and customer-focused behavior. Ovation Healthcare seeks talented, motivated professionals to help independent hospitals thrive, offering collaboration with highly skilled subject matter specialists and operations executives in a professional and team-oriented atmosphere. The corporate headquarters is in Brentwood, TN. This specific role, with ruralMED Management Resources (an Ovation Healthcare partner), is for a Hospital Outpatient Specialty Coder. Under general direction, this position is responsible for critical access hospital coding, including emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic, ensuring timely and accurate coding of medical claims to maximize reimbursement for services.

Requirements

High School Diploma or GED
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
Knowledge of medical terminology
Proficient with Microsoft Office
Demonstrated strong verbal and written communication skills
Ability to use multiple client systems and manage competing priorities
Enthusiasm for a remote teamwork environment

Nice To Haves

Associate Degree
Three to five years in emergency room coding, infusion coding, specialty clinic procedure coding
Two years’ experience with formal coding training
Critical Access Hospital and/or Rural Health Clinic coding is a plus

Responsibilities

Receive and review charge entry data from practice sites
Identify and investigate incomplete or missing charges
Abstract clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems
Sequence codes according to established guidelines
Thorough analysis and interpretation of medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement
Maintain current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers
Maintain proficient knowledge of EHR, as well as any other systems to perform job duties
Communicate issues to management, including payer, system, or escalated account issues
Identify medical necessity denial trends and provide suggestions for resolution
May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution
Participation in department meetings, in-service programs, and continuing education programs
Convey professional attitude with patients, visitors, physicians, office staff and hospital personnel
Assure confidentiality of patient information, maintaining compliance with policies and procedures
Perform other duties as assigned