Outpatient Coder 2 Certified / HIM Coding

Hartford HealthCare Corp.•Farmington, CT

About The Position

The Outpatient Coder 2 Certified reviews and validates outpatient and professional clinical documentation and diagnostic results. The role extracts data and assigns alphanumeric codes for billing, internal and external statistical reporting, research, regulatory compliance, and reimbursement. It codes complex diagnostic and procedural accounts across areas including professional specialty services, emergency services, observation, same-day surgery, pain clinic, infusion services, electrophysiology, cardiac catheterizations, LifeStar, orthopedics, and critical care. The position analyzes medical records and interprets documentation to assign appropriate ICD-10-CM, CPT/HCPCS, modifier, and Evaluation & Management codes using designated coding software, computer-assisted coding and/or encoder tools, manuals, and reference materials. It also resolves coding and charging issues, collaborates with clinicians to clarify documentation, meets revenue-cycle productivity and quality expectations, and may assist with training new coders.

Requirements

Associate’s degree or equivalent experience.
At least two years of progressive on-the-job experience in an acute care hospital or physician’s office.
CPC, COC, or CCS certification, which must be maintained.
Strong written and verbal communication skills.
Strong knowledge of ICD-10-CM diagnostic codes and CPT/HCPCS procedure codes.
Knowledge of clinical information related to assigned areas of responsibility.
Knowledge of Microsoft Office products, including Word and Excel.
Knowledge of an encoder and/or computer-assisted coding product.
Proficient English reading, writing, and speaking skills.
Strong analytical and organizational skills.
Ability to read and interpret physician documentation proficiently.
Ability to function independently, handle multiple priorities, listen attentively, communicate clearly, collaborate, influence positive outcomes, use independent judgment to solve problems, and work across the Hartford HealthCare System.

Nice To Haves

Two to four years of progressive on-the-job experience in an acute care hospital or physician’s office.

Responsibilities

Apply knowledge of anatomy, physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to assign diagnosis and procedure codes.
Analyze medical records and assign ICD-10-CM, CPT/HCPCS, modifier, and Evaluation & Management codes using designated software and reference materials.
Enter charges for procedures that are not soft coded for designated patient types.
Follow department coding and charging procedures, policies, guidelines, and quality standards.
Complete assigned cases daily using the appropriate work lists.
Code complex diagnostic and procedural accounts across the listed clinical service areas.
Assist the manager with special projects and other assigned tasks.
Follow AHIMA/AAPC Standards of Ethical Coding and official coding guidelines.
Meet revenue-cycle KPIs and productivity standards.
Review claim edits and revise coding or charging as appropriate.
Review accounts returned by departments such as Customer Service, Billing, Coding Quality, and Revenue Integrity; process corrections for clean claim submission or post claim-denial reviews for appeal.
Seek clarification from physicians or other staff when documentation is absent, ambiguous, or contradictory.
Make corrections in collaboration with a clinician or designee.
Assist with training new coders on the work environment, internal coding policies and procedures, and documentation guidelines when assigned.