Outpatient Acute Care Coder

Outpatient Acute Care Coder

Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA.

The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance. Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.) Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures. Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Ability to assign Physician E/M levels and charges for all relevant procedures performed in various settings, if applicable. Ability to assign injections and infusions, if applicable.

Qualifications: One to three years' experience performing medical record coding in acute care setting required. High school diploma or equivalent is required. Associate of bachelor's degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed preferred. Years of coding experience will be considered in lieu of educational requirements. Functional Knowledge of EMR (Electronic Medical Record), Encoder and CDI Tools and other Support Software. Comprehensive understanding of UHDDS guidelines, CCI Edits, Coding Clinic, etc. Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint) proficient. Excellent verbal and written communication skills. Ability to meet assigned deadlines.

Work Experience, Education, and Certifications: Associate degree preferred. 1 year of Acute/Physician Coding Experience. AHIMA or AAPC Certification required such as RHIA, RHIT, CCS, CPC, CIRCC, COC. Software/Hardware: 3M360 experienced required.

Benefits: Competitive salary and benefits package. Opportunities for professional development and advancement. Supportive work environment with a collaborative team. Comprehensive healthcare coverage. Retirement savings plan. Paid time off and flexible scheduling options. Student loan repayment program.

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