Specialty Coder Outpatient – Remote
Aurora St Lukes Medical Center – 2900 W Oklahoma Ave
job requisition id
10347 WI Revenue Cycle – Hospital Coding
Hours Per Week:
Schedule Details/Additional Information:
- Full time occasional weekends.
- This is a REMOTE Opportunity
Responsible for final coding of outpatient accounts types for GI, Pain Clinic, Radiation Oncology, Wounds, Outpatient Specialty single and series accounts, and infusion coding.
This position is responsible for accurately assigning and sequencing diagnosis codes using ICD-10-CM in accordance with advice from Coding Clinic and ICD-10-CM Official Coding Guidelines. This position is accountable for utilizing 3M coding products including encoder and groupers for Medicare reimbursement and other third party payors, and for internal Advocate business and quality purposes.
This position is accountable for accurate abstracting of selected clinical and non-clinical information to create a comprehensive database of information for billing purposes, internal data management, and external reporting of data.
Codes diagnoses utilizing a computerized encoding software system and completes abstraction for clinical data and non-clinical data elements for community hospital sites.
This position is responsible for reviewing all documentation in the patient record for accurate and complete code assignment in accordance with the current International Classification of Disease, Clinical Modification (ICD-10-CM).
Maintains a productivity rate of 100% or more on a monthly basis and 95% quality.
Responsible for assigning ICD-10-CM diagnosis codes and CPT codes for the following specialty areas: GI Lab, Pain Clinic, Radiation Oncology, Wound Care, high cost drugs, as well as assigning infusion charges for observation and day surgery accounts.
Responsible for assigning diagnosis codes and CPT codes for Emergency Room/Urgent Care accounts.
Responsible for assigning diagnosis codes and CPT codes for Office Visits, including consisting of and not limited to: epilepsy, neuro, psycho cancer, women’s wellness, transplant, and behavioral health.
Responsible for reviewing all documentation in the patient record to identify all relevant diagnoses and procedures for coding accuracy.
Codes diagnoses and procedures utilizing the 3M360 encoding system and has knowledge in EPIC Chart Production.
Selects and assigns codes for the appropriate first listed and all additional diagnoses according to Outpatient Coding guidelines with the official ICD-10-CM coding and reporting guidelines.
Assists in ensuring coding compliance with federal, state, and other regulatory agencies, research cases, government payors and other selected third-party payors.
Locates and utilizes the necessary resources to solve coding questions as they arise during the performance of daily duties.
Attends educational seminars and in-services to satisfy continuing education requirements to maintain certification(s). Reviews periodicals and literature to remain abreast of changes that will affect coding and reimbursement methodologies. Achieves productivity expectations to support discharged not final billed (DNFB).
Attends monthly coding meetings as required.
Promotes patient safety by reporting of issues through established channels and participating in safety initiatives.Safeguards confidential and privileged patient information.
Licenses & Certifications
- Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA), or
- Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
- Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
- Associate’s Degree in Health Information Management or related field.
Required Functional Experience
- Typically requires 3 years of experience in coding and demonstrates competency in outpatient specialty cases in an integrated acute care teaching setting.
Knowledge, Skills & Abilities
- Proficient in Microsoft Office, Word, Excel, and PowerPoint. Advanced knowledge and understanding of anatomy, physiology, medical terminology, pathophysiology (disease process, surgical terminology and pharmacology) and is able to apply these sciences to accurately assign codes to cases.
- Expert knowledge in coding of wound care, high cost drugs, pain clinic, and GI.
- Expert knowledge and experience in ICD-10-CM, CPT, and 3M Encoder.
- Demonstrates knowledge of National Council on Compensation Insurance, Inc (NCCI) edits, and local and national coverage decisions.
- Expert knowledge and experience in ICD-10-CM and CPT coding systems, G-codes, HCPCS codes.
- Current Procedural Terminology (CPT), modifiers, and Ambulatory Payment Classifications (APC).Advanced knowledge of pharmacology indications for drug usage and related adverse reactions.
- Expert knowledge of coding workflow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems.
- Excellent communication and reading comprehension skills.
- Demonstrated analytical aptitude, with a high attention to detail and accuracy. Experienced with remote workforce operations required. Strong sense of ethics.
What We’d Like to See
- Experience with Emergency Department, Behavioral Health, and Clinic Visits