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Outpatient Coder II

Roles & Responsibilities

  • Associate degree or equivalent experience
  • Knowledge of ICD-10-CM, CPT-4, Disease Pathology, Anatomy, Physiology and Medical Terminology
  • Certification from AAPC or AHIMA (e.g., CPC, CPC-H, COC, CCS, CCS-P, RHIA, RHIT)
  • 2-4 years of outpatient coding experience

Requirements:

  • Codes all outpatient medical records in a timely and accurate manner according to department policy
  • Uses ICD-10-CM and CPT-4 to assign codes based on clinical descriptions
  • Initiates physician/department queries when documentation is incomplete or ambiguous to ensure accurate coding
  • Enters required information into the computer system for reimbursement and statistical purposes and, as applicable, reconciles charges

Job description

Description

Position at Nuvance Health

At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your career.

Summary:

Accurately codes and abstracts outpatient medical records for reimbursement and statistical purposes using established coding guidelines. Reviews coding and amends coding edits to assure compliance with all applicable regulations.

Responsibilities:

  1. Codes all outpatient medical records in a timely and accurate manner according to department policy.
  2. Defines and transforms verbal descriptions of diseases, injuries, and procedures into numerical designations (codes) using ICD-10-CM and CPT-4 according to established coding guidelines.
  3. Initiates a physician/department query when there is conflicting, incomplete, or ambiguous documentation in the record or additional information is needed for accurate coding. 
  4. Enters all required information accurately into computer system for reimbursement and statistical purposes.
  5. As applicable based on facility workflow, independently reconcile charges for areas of responsibility. Uses patient schedule together with billing slips to identify missing charges. researches and resolves discrepancy so charge keyed reflect services delivered.
  6. Performs ICD-10-CM diagnostic and CPT-4 coding at a minimum accuracy rate of 95%. 7.
  7. Remains abreast of all applicable Federal, State, regulatory and hospital-specific coding guidelines.
  8. Applies applicable guidelines to all cases coded to ensure accuracy of selected codes.
  9. Accesses and research applicable reference materials to further support decision-making in code selection.
  10. Participates in Performance Improvement/Quality Assurance activities.
  11. Reports on software and hardware problems.
  12. Attends required educational sessions (webinars, conferences etc.) to maintain and enhance coding certification(s)
  13. Maintains and Model the Organization�s values. 
  14.  Demonstrates regular, reliable and predictable attendance.
  15. Performs other duties as required.

Education Skills Experience

  • Associate degree or equivalent experience
  • Knowledge of ICD-10, CPT-4, Disease Pathology, Anatomy, Physiology and Medical Terminology
  • Advanced knowledge of Evaluation and Management Coding guidelines
  • 2-4 years of coding experience
  • Familiarity with MS Office applications
  • Usage of coding manuals and regulatory websites for research
  • Certification from the America Academy Professional Coders (AAPC) or the American Health Information Management Association (AHIMA): CPC, CPC-H, COC, CCS, CCS-P, RHIA, RHIT, or specialty certification required.

Minimum Knowledge, Skills, and Abilities Requirements:

CPC, CPC-H, CCS, CCS-P, RHIA, RHIT, or specialty certification required.

    With strong hearts and open minds, we’re pushing past boundaries and challenging the expected, all in the name of possibility. We are neighbors caring for neighbors, working together as partners in health to improve the lives of the people we serve. If you share our passion for the health of our communities, advance your career with Nuvance Health!

    Working Conditions:

    Manual: Little or no manual skills/motor coord & finger dexterity

    Occupational: Little or no potential for occupational risk

    Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

    Physical Environment: Generally pleasant working conditions

    Company: Nuvance Health

    Org Unit: 2069

    Department: CODERS - PROFESSIONAL & FACILITY CHARGING and CODING

    Exempt: No

    Salary Range: $26.48 - $50.49 Hourly

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