Coder I

Under the direction of the Health Information Management Director, the Outpatient Coder I accurately determines ICD-10-CM diagnosis, ICD-10-CM, CPT and HCPCS procedure codes for all outpatient medical records, which may include Emergency Department (ED), outpatient laboratory, diagnostic imaging, minor outpatient procedures, infusion and injections, outpatient labor and delivery, recurring accounts and observation stays.

POSITION RESPONSIBILITIES

Abstract pertinent information from patient records within various outpatient types and assign appropriate ICD-10-CM, ICD-10 PCS, and HCPCS codes, creating ambulatory payment classifications (APC). Monitor and manage the discharged not final billed (DNFB) accounts within assigned patient types daily to meet financial goals and expectations. Meet coding productivity standards and accuracy rates as determined by company policy. Query clinical staff to achieve accuracy in coding. Educate, train and communicate with medical staff regarding accurate documentation for coding purposes. Keep abreast of coding guidelines and reimbursement reporting requirements; bring identified concerns to supervisor or department manager for resolution. Abide by the Standards of Ethical Coding set forth by the American Health Information Management Association and adhere to official coding guidelines. Abstract data and report to the Virginia Trauma Registry. Participate in the appeals process for coding denials, including initiating and responding to billing requests to support medical necessity, appropriateness of code assignment, combining accounts based on payer requirements and other activities to support the billing function. Answer telephone inquiries and respond to requests in a professional, timely manner. Maintain professional credentials through ongoing coding education as well as company requirements for annual continuing education. Contribute to quality improvement activities of the department and the organization, including participation in internal department and corporate audits. Participate in other department or organizational activities as requested. KNOWLEDGE, SKILLS and ABILITIES Effective oral and written communication skills. Demonstrated competence with personal computers, networks, and Microsoft Office. Experience with various abstracting and coding systems and electronic health record systems. Ability to work independently or as a team member to accomplish tasks or projects. Ability to prioritize work assignments during periods of stress. Ability to sit for long periods of time. Corrected visual acuity for long periods of reviewing/reading medical records and viewing a computer monitor. Knowledge and skills to correctly assign reason for visit/first listed diagnosis for outpatient encounters and to assign additional diagnoses based on coding rules and guidelines. Critical thinking, time management, and organizational skills.

AGES OF POPULATION SERVED

Age Specific Yes No Birth to One Year – Infant 2 – 3 Years – Toddler 4 – 5 Years – Pre‑Schooler 6 – 11 Years – School Age 12 – 17 Years – Adolescent 18 – 30 Years 31 – 64 Years – Adult 65+ Years – Geriatric No responsibility to treat or care for patients

WORKING CONDITIONS

Exposure to: None, Some, Frequent Exposure to high‑pitched noises 50% of time spent traveling

PHYSICAL DEMANDS / LIFTING REQUIREMENTS

Lifting 10 lbs. maximum and occasionally lifting and/or carrying articles. Frequent lifting and/or carrying of objects weighing up to 10 lbs. Use or viewing of computer monitor >75%. Ability to sit for long periods of time, repeated bending, stooping, kneeling, and crouching; working in confined areas; standing/walking >25% of shift; multi‑tasking with frequent interruptions; hand/eye coordination; critical thinking skills; reaching above shoulder level.

POSITION REQUIREMENTS

Post‑high school specialty or vocational training with a specialization in courses in medical terminology, anatomy and physiology, basic disease process, ICD‑10‑CM and CPT‑4 or equivalent competency. Successful completion of a coding certificate program in a program with American Health Information Management Association approval status. Minimum of 1 year of acute hospital coding and abstracting experience. Experience and/or education in ICD‑10‑CM / ICD‑10 Procedural Coding System (PCS) coding. Certification or licensure as a Certified Coding Specialist (CCS) or must obtain CCS credential within 2 years (required). Or registered Health Information Administrator (RHIA) or Certified Professional Coder – Hospital (CPC‑H). And must obtain the CCS credential within 2 years of employment or have equivalent acute care coding and abstracting experience. #J-18808-Ljbffr LifePoint Health