OUTPATIENT CODER (OCCASIONAL ONSITE REQUIRED)

The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social.

Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation.

Contributes to organization success targets for patient satisfaction.

F ormulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members.

A dhere to coding rules for outpatient coding, APC assignment, outpatient coding CCI edits and other to ensure quality coding based upon documentation with the patient record.

M ay also code skilled care or rehab services with involves CMG assignment and IRFPAI completion.

F ollows policies, procedures, and guidelines to assure consistent coding quality. At the same time, utilizes analytical skills when reviewing charts, interpreting documentation, and applying codes, sufficing edits, reviewing pertinent charges, etc.

A ssures coding is completed timely and all work queues are maintained at a reasonable completion rate/turnaround timeframe. This includes the willingness to help others, accepting help from others and the ability to work extra when backlogs occur.

P articipates in HIM department meetings and area specific meetings (OPC, charge master, clinical areas, resident/physician meetings, etc.) as required.

A ssist in achieving departmental, AR and area specific goals.

M ay also be required to work with external vendors/customers on issues, audits, or projects.

H elps to identify solutions to problems and assists in resolving issues.

P articipates in identifying lean opportunities to enhance coding efficiency and lower AR.

S hares knowledge during training of new staff and is a resource to others.

I ndependent learning with desire for continued personal and professional growth. Stays current on coding updates such as Coding Clinics, code updates/changes.

U tilizes numerous references to support technical decisions, clinical understanding of disease processes or procedures/tests performed.

M aintains professional credentials.

A ssist CBO/Finance/Data/CMG/Patient Safety and Quality/Other as requested for follow up on items related to coding, billing, reimbursement. Assure that all legal requirements, including Federal (HIPAA) and State regulations are followed.

D emonstrates an awareness of legal/confidentiality issues and adheres to all HIPAA Privacy and Security and department policies and procedures.

P articipates in the development and attainment of department and workgroup goals.

P erforms other duties as assigned which may include reviewing, analyzing coding denials, denial appeals, denial entry, writing appeal letters to outside agencies, coding quality reviews, training of new staff, mentoring students, or testing for new software upgrades.

H elp develop or maintain guidelines, procedures, or policies.

EDUCATION/EXPERIENCE REQUIREMENTS

R HIA, RHIT, or CCS credential required.

E ligible Bachelor or Associate Degree graduates will be considered with the expectation they pass the national exam.

A cute care outpatient coding experience preferred (diagnosis and procedural coding utilizing ICD10CM and CPT-4 coding books and references including NCCI edits or modifiers).

C linical documentation knowledge of outpatient coding preferred.

K NOWLEDGE/SKILLS/ABILITIES

B asic computer skills.

M ust be able to tolerate working under stress, limited constraints and with frequent interruptions and deadlines.

K nowledge of standard office equipment.

K nowledge of computer use including EMR, email/Outlook, internet, encoder, and other software as needed (Vital Ware, Lawson, Excel).

D emonstrates effective communication methods and skills, both verbally and in writing.

U ses appropriate organization/priority setting skills to complete work timely and accurately.

P ractices effective problem identification and resolutions skills as a method of sound decision making.

D emonstrates interpersonal skills required to work with many other people and personalities.

A bility to use sound judgement, based upon the latest guidelines, federal and state statutes, and regulations, as well as hospital and departmental policies.

O ngoing professional growth in many areas.

A bility to sit and look at computer screen for long periods of time.

A bility to be flexible to adjust assignments as priorities change.

W ORKING CONDITIONS/PHYSICAL REQUIREMENTS

A bility to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.

C onstant sitting, use of hands to finger, handle and feel.

C onstant hearing and near vision.

F requent depth perception, midrange and far vision.

F requent color and field of vision.

F requent lifting 0-10lbs.

O ccasional standing, walking, carrying, pushing, pulling, climbing, balancing, stooping, kneeling, crouching, squatting and crawling.

O ccasional twisting, reaching and talking.

O ccasional lifting 11-50lbs.