Outpatient Coder III - HF Coding and Documentation

Job Requirements

Candidate to be considered must reside in the state of Florida. This is a work from home opportunity with majority being remote work.

Position Summary

To be fully engaged in providing timely, complete, and accurate data collection for quality clinical analysis and revenue enhancement.

Primary Accountabilities

1. Uphold regulatory compliance by assigning and sequencing accurate ICD 10 and CPT 4 codes to reference lab, ancillary, emergency room, endoscopy, ambulatory surgery, observation, and other outpatient records as per coding guidelines demonstrating behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.

2. Validate accuracy of codes assigned by the computer assisted coding software, recognizing inappropriate application of clinical coding rules/guidelines, and revising the codes assigned based upon expert subject matter knowledge and provider documentation.

3. Literacy and proficiency in computer technology specifically related to health information and coding applications utilized for daily job performance.

4. Interpret clinical documentation to ensure codes reported are clearly and consistently supported by the health record.

5. Request clarification from provider when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element.

6. Abstract pertinent information accurately and completely into the computer assisted coding application.

7. Maintain coding quality and productivity as per departmental standards.

8. Competent in analyzing medical necessity of codes assigned utilizing and applying local and national coverage determination regulations and guidelines.

9. Responds timely to pre-bill edits received ensuring a prompt turn-around-time to assist in facilitating an efficient revenue cycle.

10. Communicates professionally identified discrepancies, documentation issues, denial management issues and coding concerns in the medical record to the appropriate department and/or leader.

11. Stays up to date with regulatory changes by completing all mandatory educational accountabilities in a timely manner.

12. Attends department meetings and other outpatient meetings as scheduled.

13. Accurate and ethical time and attendance recording ensuring non-productivity logs are completed and submitted by deadline set.

14. Provide departmental coding coverage by cooperating with occasional schedule revisions and overtime requests when staffing needs arise assisting with maintenance of discharge not final coded (DNFC) departmental goals.

15. Maintain and observe patient confidentiality as outlined in the National Patient Safety Goals and HIPAA guidelines always protecting the confidentiality of the health record and refusing to access protected health information not required for coding-related activities.

Work Experience

Minimum Qualifications

Education: High School Diploma or equivalent.

Work Experience: Three (3) years outpatient coding experience.

Licensure: None

Certification: None

Skills/Knowledge/Abilities:

• Competent in understanding medical terminology.
• Basic understanding of anatomy and physiology.
• Excellent communication, problem solving and critical thinking skills.
• Utilize critical thinking skills and formulate logical decisions to apply clinical coding guidelines to health record documentation.
• Strong written and oral communication skills for professional interaction.
• Excellent computer and telephone skills.
• Ability to read and comprehend instructions, correspondence, memos, and electronic mail.
• Must be detail and accuracy oriented.
• Ability to coordinate and use logical reasoning to facilitate daily workflow assignments.
• Ability to multi-task.
• Ability to work independently maintaining focus on scope of work assigned.

Preferred Qualifications

Work Experience: Five (5) years outpatient coding experience.

Certification: Any one of the following:

• American Health Information Management Association (AHIMA) OR
• American Academy of Professional Coders (AAPC).

Physical Requirements

Majority of time involves sitting or standing; occasional walking, bending, and stooping.

Long periods of computer time or at workstation.

Light work that may include lifting or moving objects up to 20 pounds with or without assistance.

May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise.

Communicating with others to exchange information.

Visual acuity and hand-eye coordination to perform tasks.

Workspace may vary from open to confined, onsite, or remote.

May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle.

Benefits

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

Health First Shared Services