Outpatient Senior Coder

Conifer Health Solutions • Frisco, TX

2d • $25 - $37

About The Position

JOB SUMMARY Responsible for assigning diagnostic and procedural codes (outpatient surgery, observation, infusion services, and interventional procedure records) to patient charts of moderate to high complexity using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Coding: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition. Coding Quality: Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by per facility. Goal: Average coding quality standard of =/>95% accuracy per monitoring period. Does not meet =<95% accuracy Meets => 95% accuracy Exceeds =>95.01% accuracy Coding Labor Productivity: Meets and/or exceeds Conifer’s coding productivity guidelines. Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding. Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-10-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls Communicates and resolves coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution

Requirements

• Proficient in outpatient diagnosis coding guidelines
• Proficient in CPT/HCPCS code assignment including Evaluation & Management facility coding guidelines
• Ability to assign corresponding PCS codes (after dates of service 10/1/2014)
• Working knowledge of the Outpatient Prospective Payment System (OPPS)
• Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager
• Ability to establish and maintain effective working relationships as required by the duties of the position
• Ability to concentrate and accomplish tasks with explicit accuracy
• Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency
• Functional knowledge of facility EMR, encoder and other support software
• One year of experience performing medical record coding in acute care setting preferred
• High school graduate or equivalent is required
• Completion of basic coding course (academic, seminar, workshop or facility-based), including medical terminology and basic anatomy and physiology, or an equivalent combination of education and experience also required
• AHIMA or AAPC approved credential

Responsibilities

• Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures.
• Adheres to Standards of Ethical Coding (AHIMA).
• Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition.
• Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures.
• Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by per facility.
• Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding.
• Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-10-CM and CPT updates) for inpatient and outpatient coding.
• Quarterly review of AHA Coding Clinic.
• Attends Quarterly Coding Updates and all coding conference calls
• Communicates and resolves coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution

Benefits

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees