Outpatient Coding Specialist, Remote

CGH Medical Center

2d•$18 - $27•Remote

About The Position

Reviews the contents of moderate to minimally complex medical records, assigns appropriate ICD-10-CM diagnosis, abstracts pertinent data for claims processing, data retrieval and analysis. Abides by the Standards of Ethical Coding as set forth by the American Health Information Association and adheres to official coding and reporting guidelines, and hospital-specific guidelines. Maintains knowledge of pertinent federal regulations related to ancillary coding and reimbursement.

Requirements

CPC, CPC-A, CCS, CCS-P, CCA credential required; if CPC or CPC-A certified required to be AHIMA CCA credentialed within 2 years of hire. For advancement to other coding positions such as Inpatient coding specialist or Outpatient Coding II Specialist, a CCS or CCS-P must be obtained within 2 years of hire for those positions.
Basic PC and PC maintenance skills required.

Nice To Haves

Coding experience in a medical center preferred
Working knowledge of regulatory requirements, understanding of APC’s, modifiers and accounts receivables preferred.

Responsibilities

Reviews the contents of the ancillary medical record to identify the diagnoses to be coded, ensuring that all conditions are properly documented and ordered by the provider and sequenced appropriately.
Utilizes the encoder to properly assign ICD-10-CM codes, adhering to the Uniform Hospital Discharge Data Set Guidelines, the official coding and reporting guidelines, and Coding Clinic guidelines.
Verifies medical necessity criteria are met by reviewing encoder edits and review of CMS policies. Resolves potential medical necessity denials by review of physician documentation and orders in the electronic record.
Verifies specific charges in billing system (Cerner) to assure charging timeliness and accuracy. Communicates with appropriate department manager, or designee of problems with charges.
Participates actively in the Revenue Cycle by monitoring the Prebill report to complete coding in a timely manner.
Participates in education and training as directed by Coding Manager. Maintain coding credential through continuing education provided by CGHMC.