Certified Surgical Coder

Job Summary Location: Methodist Corporate Office Address: 825 S 169th St., Omaha, NE Work Schedule: Mon - Fri, full-time, flexible 8-hour daytime shifts Codes professional charges for surgical procedures for inpatient and outpatient services, including correct CPT, ICD-10-CM, and modifiers in accordance with medical policies and guidelines. Responsibilities Assigns ICD-10-CM diagnosis, CPT procedure codes, and HCPCS device codes as necessary to outpatient records to ensure maximum reimbursement, utilizing ICD-10-CM and CPT principles of code assignment and UHDDS definitions of principal and secondary diagnosis. Accuracy rate of at least 95% Enters ICD-10-CM diagnosis code(s) and CPT procedure code(s) into the code summary to maintain disease and operation index, allowing timely submission of claims to insurance companies by assigning correct diagnosis and procedure codes and the reason for the encounter per department procedure. Accuracy rate of at least 95% Reviews CPT procedure codes and HCPCS device codes in the code summary and charge viewer to ensure all accounts reflect appropriate charges for services and devices provided; reviewing CCI edits, attaching modifiers, and adding or modifying charges to the account. Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on insurance billing updates. Reviews coding with Physician 95% of the time. Per provider request. Per departmental audit standards. Investigates claim denials from third-party payers to ensure accuracy by reviewing services received and patient accounts, making any coding/charging corrections. Per department process regarding code reviews within 14 days of receipt. Per request from clinic personnel. Per request from Business Office and/or Customer Service Personnel. Ensures timely submission of claims to insurance companies by maintaining accounts receivable within 3 days of discharge on all outpatient encounters; maintains minimum productivity standards: Codes 7 OPS encounters per hour. Codes 5 OBS encounters per hour. Codes 12 Infusion Center encounters per hour. Codes 10 GI/Pain Management encounters per hour. Codes 30 Radiology/OP Diagnostic services encounters per hour. Codes 15 Recurring encounters per hour. Codes 25 Non-patient Pathology Encounters per hour. Codes 15 Emergency Department encounters per hour. Codes 12 Professional Services encounters per hour. Utilizes and understands how to view and make appropriate changes in the charge viewer to ensure maximum reimbursement. Job Requirements Education: High School Diploma or G.E.D. required. College-level completion of courses in anatomy and physiology, biology, disease process, and medical terminology required. Associate's Degree in Health Information Management or healthcare-related degree preferred. Participates in mandatory in-services and continuing education as mandated by policies and procedures, external agencies, and as directed by supervisor. Experience: 3+ years previous experience coding physician services from documentation preferred, surgical and Evaluation/Management (E/M) required. License/Certifications: Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Registered Health Information Technician (RHIT) or Certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) required. Skills/Knowledge/Abilities: Attention to detail when reviewing the medical record, verifying the diagnosis and reviewing charges at the time of ICD-10-CM and CPT code assignment. Understanding of outpatient prospective payment methodology and knowledge of national correct coding initiatives. Operational computer and Microsoft Office skills. Experience with Word, Excel, etc. Physical Requirements Weight Demands: Light work – exerting up to 20 pounds of force. Physical Activity: Not necessary for the position (0%): Climbing Crawling Kneeling Occasionally performed (1%-33%): Balancing Carrying Crouching Distinguishing colors Lifting Pulling/Pushing Standing Stooping/bending Twisting Walking Frequently performed (34%-66%): Grasping Reaching Repetitive motions Sitting Speaking/talking Constantly performed (67%-100%): Fingering/Touching Hearing Keyboarding/typing Seeing/Visual Job Hazards Not related: Chemical agents (toxic, corrosive, flammable, latex) Biological agents (primary airborne and blood-borne viruses) (jobs with patient contact) (BBF) Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment) Equipment/Machinery/Tools Explosives (pressurized gas) Electrical shock/static Radiation Alpha, Beta and Gamma (e.g., X-ray, CT scan, Gamma Knife) Radiation non‑ionizing (ultraviolet, visible light, infrared and microwaves that cause tissue injury or thermal/photochemical effects) Mechanical moving parts/vibrations Nebraska Methodist Health System is an affirmative action/equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by federal, state or local law. #J-18808-Ljbffr Nebraska Methodist Health System