Coder I - Outpatient PB Coding - Full Time

POSITION SUMMARY Review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM and CPT-4 codes for billing, internal and external reporting, research, and regulatory compliance. Under the direction of the director of Health Information Management and department director, code outpatient conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors. Examples outpatient encounters include: laboratory and non-invasive diagnostic and therapeutic encounters, and hospital-owned physician practice encounters (professional and facility E&M). QUALIFICATIONS Required : Successful completion of an AHIMA or AAPC coding certification program and certification within six months of hire. One year of coding experience. Demonstrated proficiency in medical terminology; anatomy and physiology, disease processes, signs and symptoms, medication, and lab values related to a specialty or specialties. Preferred : Associate's degree in Health Information Management or equivalent training acquired through, at least, two years of progressive on-the-job experience. RHIA, RHIT, CCS, CCS-P, CCA or CPC certification status. TYPICAL PHYSICAL/MENTAL DEMANDS Sedentary to light level capabilities required. Must be able to work independently as well as with coworkers, customers and physicians. Must be able to prioritize work demands and organize time efficiently. Must be able to sit for long periods of time. ESSENTIAL JOB FUNCTIONS Assigns codes for diagnoses, treatments, and procedures according to the appropriate classification system for complex outpatient encounters. Utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and ICD-10-CM/CPT-4 procedures. If applicable to coding worktype, identifies chargeable items and enters into billing system. Extracts required information from source documentation and enters into encoder and abstracting system. Maintains proficiency with encoding, abstracting and EMR software. Assists business office and physicians' offices with coding/abstracting problems. Ensures all services documented in the patient's chart are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, seeks to attain proper documentation in a timely manner. Communicates with physicians to resolve documentation issues or E&M level discrepancies. Reviews error reports to correct or complete missing data elements. Assists in implementing solutions to reduce back-end billing errors. Maintains 95% accuracy while meeting all productivity standards for each type of chart. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines. Performs audits and completes department projects and special studies as assigned. MARGINAL JOB FUNCTIONS Performs other duties as assigned.