Coding Specialist - Outpatient - Non-Exempt

Job Description Summary

Shift:8:00am-4:30pmLocation:Remote Mississippi

Position Overview

The Outpatient Coding Specialist will evaluate medical records and charges, as appropriate, to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-10-CM), Healthcare Common Procedure Coding System (HCPCS), and the American Medical Association's Current Procedural Terminology Manual (CPT). Reviews medical records to identify diagnosis codes and CPT procedures relative to the patient's encounter. Selects the first listed diagnosis and principal procedure, along with other diagnoses and procedures using outpatient ICD-10-CM coding conventions and guidelines as well as the general and disease specific guidelines. Abstracts appropriate information from the medical record. Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record as well as querying for medical necessity. Ensure all coding complies with the ethical coding standards/guidelines and regulatory requirements. Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations. The Specialist will also provide technical guidance and training on medical coding to physicians and staff.

DISCLAIMER: This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Education

High School diploma or equivalent required. Must have completed course work in medical terminology, anatomy, physiology, disease processes, ICD-9/10-Clinical Modification coding, and/or CPT coding.

License

N/A

Certifications

• CPC: Certified Professional Coder;
• COC: Certified Outpatient Coder;
• CCS-P: Certified Coding Specialist-Physician-based;
• Or other equivalent coding certification.

Experience

One (1) year of healthcare-related work experience or coding experience directly applying codes preferred, or the equivalent combination of expertise, education, and training that would provide the required knowledge and abilities.

Reports to

Coding Manager

Supervises

None

Physical Demands

Work is moderately active: involves sitting with frequent requirements to move about the office, move about the facility, and to travel to another facility within the SRHS service area. Work involves exerting a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Work involves using many physical motions in performing daily work activities; subject to exposure of body fluids, sputum and tissues, which may carry the hazard of infectious disease. Work involves using repetitive motions: substantial movements of the wrists, hands, and or fingers while operating standard office equipment such as computer keyboard. Work involves being able to perceive the nature of sound at normal speaking levels with or without correction; the ability to make fine discriminations in sound. Work requires close visual and acuity and the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms/printed material that are closer to compare data at close vision. Must be able to be active for extended periods of time without experiencing undue fatigue. Must be able to work schedules assigned with the understanding that changes may be instituted according to the needs of the hospital for off days, shifts or weekends.

Mental Demands

Must demonstrate keen mental faculties/assessment and decision making abilities. Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone. Must demonstrate strong written and verbal communication skills. Must possess emotional stability conducive to dealing with high stress levels. Must demonstrate ability to work under pressure and meet deadlines. Attention to detail and the ability to multi-task in complex situations is required. Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations.

Special Demands

Must possess superior customer service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.), MS Outlook and Word. Must be able to demonstrate appropriate clinical judgment and apply appropriate professional skills to a patient population of all ages.

• Knowledge of ICD-10-CM and CPT/HCPCS coding guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines; fluent English grammar and usage.
• Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.
• Ability to read and interpret medical procedures and terminology.
• Ability to exercise independent judgment.
• Excellent written and verbal communication skills to prepare queries and related documents and to maintain working relationships with physicians and other staff.
• Ability to maintain confidentiality.

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