Coder

Health Information Management

Coupeville, WA

Service / Support

Full-time, Days 8 hour, Monday-Friday

FTE 1

Posted 07/02/2025

Req # 16196

Work Location: Remote

JOB SUMMARY

The Coder I, II supports the mission of providing quality healthcare to the patients of WhidbeyHealth to ensure encounters are charged and coded accurately and efficiently. This position may be responsible for applying the appropriate codes for ICD-10, CPT / HCPCS, evaluation and management, and/ or modifiers to encounters for claims processing, or assessing, charging, and reconciling encounters. The Coder follows all federal, state and payer specific regulations and policies pertaining to documentation and coding requirements to ensure all work is in compliance with quality and established guidelines.

Coding positions within this Job Description are meant to encourage job growth with applicable career ladders. Prior to moving to a higher level coding position, a Coder must meet the standards under the applicable career ladder before transfer to the new level will be made. Career ladders are not automatic and must be approved by the applicable Manager prior to movement to a higher level. Coder 1 may be used as a training position for a Charge Only Position.

PRINCIPLE FUNCTIONS includes the following, other duties may be assigned:

RESPONSIBILITIES

CODER l:

Outlined Below Is a Summary Of Charging And Coding Specific Duties And Responsibilities That Are Shared Among Department Staff. The Specific Areas Of Responsibility Will Be Assigned By The Department Manager And Reviewed With The Employee; Employee May Be Asked To Perform In Any Or All Areas:

• Ensures all appropriate charges are ordered, captured, documented, charged and reimbursed for the assigned outpatient, inpatient department and /or clinic.
• Understands ICD-10 PCS and / or ICD-10 CM standards.
• Will use appropriate tools and/or books to support proper assignment of codes and charges.
• Coding areas may include Lab, Rehabilitative Services, Palliative Care, ED, and / or other areas as assigned by Manager. Will not include coding IP, OBS, ASC services.
• Daily charge audit reconciliation functions will be performed to ensure accuracy.
• Performs regular auditing and monitoring of charge capture.
• Working with the appropriate department/clinic team members, identifies, researches and analyzes coding and billing errors. Promptly code and correct as needed.
• Prioritizes duties to ensure charge capture is completed timely and accurately per rules, regulations, and policies, as set forth.
• Meets or exceeds an accuracy rate of 95%
• Applies appropriate charge modifiers.
• May provide training to staff engaged in coding and billing data entry and related charge capture/reconciliation activities.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPC).
• Adheres to official coding guidelines published by the American Medical Association, American Hospital Associate and coding clinic guidelines.
• Experience in reviewing Provider documentation and orders to ensure appropriate coding assignments.
• Familiar with NCCI edits and LCD / NCD standards.
• Charge and code according to specific related production standards for each area.
• All cases will be charged within 4 days of service except in those cases where additional documentation or late charges apply.
• All other work duties as assigned by Manager.
  
  

A Coder I is eligible to move to Coder ll after the completion of two (2) consecutive years as a Coder l with the proven ability to perform all essential functions and competencies of the position with no recent performance improvement documentation on file.

JOB KNOWLEDGE & QUALIFICATIONS

Education / Training / Experience

• Completion of AHIMA / AAPC training course or comparable medical billing and coding certificate program required and/ or two (2) years of previous coding experience required.
• High school diploma or equivalent required. This position is considered an entry level / training position.
• Candidates may be placed in this position as a trainee with the expectation that applicable coding and/or charge classes will be completed within six months of placement into coder I.
  
  

Certificates, Licenses, Registrations Preferred

CCA, CCS, CPC, or COC

RESPONSIBILITIES

CODER ll:

A Coder ll may perform Coder l duties.

Outlined Below Is a Summary Of Coding Specific Duties And Responsibilities. The Specific Areas Of Responsibility Will Be Assigned By The Department Manager And Reviewed With The Employee; Employee May Be Asked To Perform In Any Or All Areas:

• Proficient in ICD-10 PCS and / or ICD-10 CM standards.
• Assigns accurate diagnostic and procedure codes according to clinical documentation and official coding guidelines for outpatient medical records and patient types as noted in Coder 1.
• Completes on-site routine and complex encounter coding for clinic and ambulatory professional services; acts as clinic site expert.
• Familiar with NCCI edits and LCD / NCD standards.
• Understands and can apply Modifiers.
• Validates orders and discharge dispositions.
• Works from assigned coding queue, completing and re-assigning accounts correctly.
• Manages accounts on ABS Hold, finalizing accounts when corrections have been made, in a timely manner.
• Meets or exceeds an accuracy rate of 95%.
• Meets or exceeds production standards as outlined by patient type.
• Stays abreast of all changes in coding conventions and coding updates.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
• All other work duties as assigned by Manager.
  
  

A Coder ll is eligible to move to Technician Level after the completion of two (2) consecutive years as a Coder ll with the proven ability to perform all essential functions and competencies of the position with no recent performance improvement documentation on file. Movement to a Coder Technician level must have proven ability to perform IP, ASC and/or Observation Coding within six months of placement into this category.

Education / Training / Experience

Completion of AHIMA / AAPC training course or comparable medical billing and coding certificate program required and/ or two (2) years of previous coding experience required. High school diploma or equivalent required.

Certificates, Licenses, Registrations

Required: CCA, CCS, CPC, or COC

OTHER SKILLS & ABILITIES

• Advanced knowledge of medical terminology including diagnostic and therapeutic outpatient procedures, abbreviations, anatomy and physiology, major disease processes, and pharmacology.
• Must have the ability to identify specific clinical findings to support existing diagnosis, or be able to substantiate listing additional diagnosis in the electronic medical record.
• Must have knowledge and be familiar with the abstracting process.
• Must demonstrate good organizational skills with an attention to detail.
• Must possess effective professional interpersonal skills as well as excellent service skills in all interactions with the ability to communicate effectively on the phone, in person and in writing.
  
  

Benefit Information and Wage Transparency: WhidbeyHealth Employees who work a 0.5 FTE or higher are categorized as, “benefit eligible”.

Click here for benefit information.

Coder 1 Wage Range: $24.528 - $42.620

Coder II Wage Range: $28.588 - $44.480

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