Outpatient Coder

Summary:

Ovation Healthcare seeks an Outpatient Coder. This role, under general direction, is responsible for coding and abstracting of diagnoses from medical records for optimal and timely reimbursement and quality reporting.

Duties and Responsibilities:

• Assigns ICD-10-CM codes for medical record accounts, including but not limited to diagnoses.

• Abstracts key data elements required for billing, regulatory agencies, and other databases.

• Reviews records for clinical pertinence and documentation to support accurate facility-based charges for services performed during the encounter.

• Communicates with providers for clarification of documentation to ensure appropriate assignment of diagnoses, procedures, and/or facility evaluation/management (E/M) levels.

• Reviews and resolves claim edits related to outpatient encounters to ensure compliant billing, including but not limited to medical necessity and NCCI/CCI edits.

• Assists with resolution of simple visit coding errors related to other outpatient visits as needed.

• Demonstrates courtesy and professionalism through interaction, appearance, attitude, and written and oral communications with visitors, co-workers, physicians, and other hospital personnel as to represent the Medical Records Services as a high-quality service area of the Hospitals.

• Maintains patient confidentiality as required by Hospitals/departmental policy and industry/legal standards.

• Acknowledges and supports Hospitals defined goals and approach to patient care; attends regular training sessions to improve patient and customer communications.

Knowledge, Skills, and Abilities:

• Skill in prioritizing and performing a variety of duties within a system that has frequently changing assignments, priorities, and deadlines.

• Ability to impart knowledge of procedures and techniques.

• Thorough working knowledge of ICD-10-CM and CPT coding systems, and federal/state regulations regarding reimbursement.

• Thorough working knowledge of the hospital information system, electronic medical record systems, and encoder.

• Working knowledge of standards for chart completion.

• Maintains Continuing Education credits in accordance with the American Health Information Management Association's and/or American Academy of Professional Coders’ requirements based upon certification(s).

• Performs qualitative analysis of records in accordance with regulatory standards and coding requirements using CPT/HCPCS and ICD-10-CM guidelines.

• Working knowledge of medical-legal rules and regulations that govern the confidentiality and release of medical information with the ability to interpret and implement the standards.

• Must maintain total confidentiality of all patient records.

• Must be comfortable working with AR teams to resolve issues.

• Must be able to pass a coding assessment.  

• Must be proficient in Microsoft Office, including Outlook, Excel, and Teams.

• Ability to multi-task and have excellent communication skills.

• Must meet and maintain a 95% quality accuracy rate and productivity standards.  

• Must have experience working in a remote environment.

Work Experience, Education, and Certifications:

• RHIT, RHIA, CEDC, COC, CPC, CCS-P or CCS Credentials

• Three or more years of Coding experience

100% Remote