Radiation Medicine Coder (Coding Specialist 3)

Oregon Health & Science University•Portland, OR

1d•Remote

About The Position

This level 3 coding position provides support to the Enterprise Coding Department for coding highly specialized services. This position requires advanced coding experience in highly specialized areas of coding, and requires certification with AAPC or AHIMA. The role involves coding at 95% or above accuracy, abstracting information from patient medical records to assign correct codes to inpatient records, outpatient surgical records, and/or observation cases. Work will be assigned in EPIC charge router work queues, requiring the assignment of correct CPT, ICD-10-CM, HCPCS, or ICD-10-PCS and DRGs for facility and/or professional charges, which may involve complex procedure and diagnostic coding within highly specialized areas. The position also requires monitoring activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP), coordinating patient encounter billing information for completeness and accuracy, and entering coding and billing information into EPIC. Additionally, the role involves resolving coding denial requests or questions with billing, reviewing clinical documentation for compliance with CMS, and establishing and maintaining procedures for coding and billing activity. The coder will serve as a resource to leadership and the coding team, develop and disseminate written procedures, train and mentor coding staff, and stay informed of current trends in coding. This position is eligible for telecommuting.

Requirements

High school diploma or GED.
Minimum of 4 years professional or hospital experience reviewing, abstracting, coding in ICD 10 CM or ICD 10 PCS, or CPT.
Certification in one of the following coding certifications from AAPC or AHIMA: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA).
Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR equivalent certification.

Nice To Haves

Accredited Coding Program, Associates or Bachelor Degree
Specialized Coding Credential.
Knowledge of OPPS guidelines and both CPT Inpatient and Outpatient coding guidelines.
CCI edits and familiarity with medical necessity guidelines, NCD and LCD requirements.
Experience using an EMR.
Some college course work or education in classes related to anatomy/physiology, medical terminology, CPT and ICD-10-CM coding.
Knowledge of CPT Outpatient coding guidelines.
CCI edits and familiarity with medical necessity guidelines.
Experience using EPIC, 3M encoder.

Responsibilities

Coding at 95% or above accuracy.
Abstract information from patient medical records to assign correct codes to inpatient records, outpatient surgical records, and/or observation cases.
Work assigned charge sessions in assigned EPIC charge router work queues.
Assign correct CPT, ICD-10-CM; HCPCS; or ICD-10-PCS and DRGs for facility and/or professional charges, which would involve complex procedure and diagnostic coding within highly specialized coding areas such as Inpatient Coding or surgical coding.
Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
Coordinate patient encounter billing information and ensure that all information is complete and accurate before submission.
Enter coding and billing information into EPIC, establish and maintain procedures and other controls necessary in carrying out all coding and billing activity.
Resolve with billing, any issues, coding denial requests or questions as part of coding denial process.
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).
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, MCMC or Tuality.
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.
Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support and mentor and orientate coding staff as necessary.
Monitor coding and billing information from CMS guidelines, Professional licensing organizations, Internal communication memos, and transmittals from coding publishers and governmental agencies to advise facility and team of billing practice changes in CPT, ICD-10-CM, and HCPCS and ensure changes are implemented to maximize revenue and reflect medical evaluation of patient encounters.
Make recommendations to coding leadership and implement remedial actions for problems.
Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
Attends coding meetings and seminars and shares knowledge with other coders.
Participates 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.
Other duties as assigned.