About the position
This level 2 coding position provides support to the Enterprise Coding Department for coding of physician's fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. For Professional Services coding positions: This position is responsible for reviewing clinical documentation and applying the correct coding and modifiers to evaluation and management services and non-surgical procedural services. This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is in compliance with Medicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentation and CMS coding guidelines. For Facility Services coding positions: This position is responsible for reviewing documentation of outpatient diagnostic and ancillary services for diagnostic radiology, pathology, and other ancillary facility services at OHSU. This position provides support to the Enterprise Coding Department for abstracting of records, coding, and charge router submission of Facility services rendered at OHSU. Responsible for meeting performance standards set for accurate and timely submission of charges and coding for professional and facility services rendered at OHSU. Working in collaboration with Enterprise Coding Leadership and billing departments, provide technical expertise regarding a broad range of third party payer and reimbursement issues. Orient peer coders or new hires to specified coding assignments. Requires maintaining an hourly productivity standard and quality standards as set by Enterprise Coding and based on Industry Standards. Will require attendance of Enterprise Coding and Clinical Department meetings via conference call and WebEx. Coding Work Queue assignment will vary based on business needs or management assignment.
Responsibilities
- Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS).
- Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry.
- Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU.
- Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
- Coordinate all billing information and ensure that all information is complete and accurate.
- Maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
- Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orientate, and mentor coding staff as necessary.
- Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
- Attend coding meetings and seminars and share knowledge with other coders. Participate in EC Huddles.
- In collaboration with Enterprise Coding Leadership, develop and disseminate written procedures to facilitate and improve billing and documentation processes.
- In collaboration with Leadership, make recommendations and implement remedial actions for problems.
- Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in CPT, ICD-10-CM, and HCPCS.
- Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, stay informed of current trends in coding.
Requirements
- High School diploma or GED.
- Minimum two years of hospital or professional services experience reviewing, abstracting, and coding medical records using ICD-10-CM and CPT coding.
- Certification in one of the following: Coding certification from AAPC or AHIMA, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through AHIMA, Certified Professional Coder (CPC) through AAPC, or equivalent certification.
Nice-to-haves
- Accredited Coding Program required: AAPC Boot Camp, AHIMA Coding Boot Camp.
- Knowledge of OPPS guidelines and both CPT Inpatient and Outpatient coding guidelines.
- Experience using an EMR.
- Knowledge of CPT Outpatient coding guidelines.
- Experience using EPIC, 3M encoder.
- Knowledge of CPT, ICD-10-CM, HCPCS, Federal Register, Federal and State insurance billing laws and Mandates.
- Proficiency with word processing and Excel spreadsheets.
- Excellent verbal and written communication skills with the ability to effectively communicate with individuals at all levels, physicians, nurses, administrative management, etc.
- Member of the American Academy of Professional Coders and Certified Professional Coder or AHIMA certification required upon hire.
- Able to pass internal coding test.
Benefits
- Comprehensive health care plans. Covered 100% for full-time employees and 88% for dependents.
- $25K of term life insurance provided at no cost to the employee.
- Two separate above market pension plans to choose from.
- Vacation- up to 200 hours per year depending on length of service, prorated for part-time.
- Sick Leave- 96 hours per year, prorated for part-time.
- 8 paid holidays per year.
- Substantial Tri-met and C-Tran discounts.
- Tuition Reimbursement.
- Innovative Employee Assistance Program (EAP).
