Outpatient Coder II

Job Information Exemption Status: Non-Exempt Hiring Range: $0.00 - $0.00 (final offer may vary based on experience, skills, qualifications, and internal equity considerations) Schedule: Monday through Friday, 7:00 a.m. – 3:30 p.m. (1 – Day Shift, 8 Hours, United States of America) Hours: 40 per week Cost Center: 99940 – 5470 ED Coding and Revenue Capture Sign‑off: This position may have a signing bonus available. A member of the Recruitment Team will confirm eligibility during the interview process. Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Major Responsibilities Upon review of the medical record, perform analysis on documentation, which includes review of tests/reports to determine the appropriate ICD‑CM (current edition) and/or CPT codes as well as modifiers. Based on account type, may assign ICD‑PCS codes, as defined by official coding guidelines and other recognized reference materials. Verify documentation is present to substantiate codes assigned. Assist in resolving incomplete and/or missing chart documentation in order to expedite coding and billing. Participate in the continuous coding audit and performance management program. Maintain coding accuracy rate of not less than 95% for optimal reimbursement as well as department productivity standards as outlined in department policies. Attend required training classes and coding in‑services each year to stay abreast of new regulations and coding guidelines. Participate in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines. Communicate to Manager when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner. Refer all unusual, questionable situations to the direct Manager. Alert management to any coding irregularities, or trends contrary to policies/procedures, so corrective measures may be taken. Adhere to the coding and billing regulations established by the American Hospital Association (AHA), American Medical Association (AMA), and Centers for Medicare and Medicaid Services (CMS). Maintain direct and ongoing communications with other coding personnel to maximize overall effectiveness and efficiency of the operation. Keep current with all coding updates and information related to correct coding. Standard Staffing Level Responsibilities Comply with established departmental policies, procedures and objectives. Attend variety of meetings, conferences, seminars as required or directed. Demonstrate use of Quality Improvement in daily operations. Comply with all health and safety regulations and requirements. Respect diverse views and approaches, demonstrate Standards of Respect, and contribute to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. Maintain regular, reliable, and predictable attendance. Perform other similar and related duties as required or directed. All responsibilities are essential job functions. Position Qualifications License/Certification/Education – Required: High School diploma or equivalent. License/Certification/Education – Preferred: Medical coding certification; Training in medical terminology from an accredited program, completing and passing certification program within one year from date of hire (Recognized programs include: American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC)); Certification as a Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician (CCS‑P). Experience/Skills – Required: Knowledge of ICD‑CM (current edition) and CPT coding systems as well as CCI edits. Knowledge of third‑party payer requirements as well as federal and state guidelines and regulations pertaining to coding and billing practices. Good interpersonal and communications skills and demonstrates professionalism. Good customer service skills with the ability to communicate efficiently. Good organizational skills with attention to detail. Ability to work independently within established guidelines. Ability to organize and coordinate multiple functions and tasks. Ability to problem‑solve, organize and prioritize workload to meet productivity benchmarks. Ability to withstand significant level of ongoing pressure, and ability to deal with individuals with tact, discretion and diplomacy. Experience/Skills – Preferred: Three (3) years of medical abstraction and outpatient coding experience or related work experience. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Primary focus is coding Emergency Medicine encounters for the technical and professional side. Evaluation and Management coding experience preferred. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We are an equal opportunity and affirmative action employer. UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at View email address on click.appcast.io. We will make every effort to respond to your request for disability assistance as soon as possible. Standards of Respect We are striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. #J-18808-Ljbffr C999 UMass Memorial Health Care, Inc.