Coder 2

Job TitleThe Coder 2 is skilled in three or more types of outpatient, Profee, or low acuity inpatient coding. The Coder 2 may code low acuity inpatients, one-time ancillary/series, emergency department, observation, day surgery, and/or professional fee, including evaluation and management (E/M) coding or profee surgery. For professional fee coding, team members in this job code are proficient for inpatient and outpatient, for multi-specialties. Coder 2 uses the International Classification of Disease (ICD-10-CM, ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS), including Current Procedural Terminology (CPT), and other coding references. These references ensure accurate coding and grouping of classification assignments (e.g., MS-DRG, APR-DRG, APC, etc.). The Coder 2 will abstract and enter required data.Essential Functions of the RoleExamines and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees.Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.Communicates with providers for missing documentation elements and offers guidance and education when needed.Reconciles billing issues by formulating the rationale for rejecting and correcting inaccurate charges.Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.Reviews and edits charges.Key Success FactorsSound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.Sound knowledge of anatomy, physiology, and medical terminology.Demonstrated proficiency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.Ability to interpret health record documentation to identify procedures and services for accurate code assignment.Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.QualificationsEDUCATION - H.S. Diploma/GED EquivalentEXPERIENCE - 2 Years of ExperienceMust have ONE of the following coding certifications: Cert Coding Specialist (CCS), Cert Coding Spec Physician Bas (CCS-P), Cert Inpatient Coder (CIC), Cert Interv Radiology CV Coder (CIRCC), Cert Outpatient Coder (COC), Cert Professional Coder (CPC), Reg Health Info Administrator (RHIA), Reg Health Information Technic (RHIT).