Job Description
Position Highlights:
The Hospital Outpatient Coder reviews, analyzes, and assigns codes for diagnoses and procedures information that uses International Classification of Diseases, Tenth Revision, Clinic Modification ("ICD- 10-CM"), Tenth Revision, Current Procedural Terminology ("CPT"), and Healthcare Common Procedure Coding ("HCPCS") coding. The Hospital Outpatient Coder promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. In addition, this position ensures compliance with established coding guidelines, federal regulations, and accreditation guidelines
Responsibilities:
• Determine the proper codes and modifiers for all billable services utilizing ICD-10-CM, CPT, and HCPCS code sets in accordance with coding compliant guidelines, federal regulations and accreditation guidelines.
• Analyzes and reviews medical record documentation in the medical record for the purpose of assigning diagnosis and CPT codes to the documentation submission to insurance payers.
• Codes for 100% of medical records/encounters for each assigned clinic or encounter type by following quality standards as outlined in the Productivity and Quality KPI Operational Guidelines - HIM Facility OP Coding
• Codes for 100% of medical records/encounters for each assigned clinic or encounter type daily following productivity standards as outlined in the Productivity and Quality KPI Operational Guidelines - HIM Facility OP Coding.
• Utilize time management to ensure that all codes are audited and correctly entered or added. All edits are resolved timely.
• Alert coding supervisor and manager of coding in identifying and analyzing problems or issues that prevent coding of encounters.
• Knowledge and expertise necessary to perform the query process to clarify and confirm clinic documentation.
• Maintain credentials/certification and education to stay current with all coding of ICD-10-CM and CPT codes and skills to accurately abstract and code medical records.
• All other duties as assigned
Credentials and Education:
• High School Diploma/GED
• Two (2) years health care outpatient coding experience with ICD-10-CM, CPT and HCPCS classification
systems for more than one outpatient specialty
Certifications Required: Must have one of the following certifications:
• (CCS) Certified Coding Specialist
• (CPC) Certified Professional Coder
• (CPMA) Certified Professional Medical Auditor
• (COC) Certified Outpatient Coder
• (CCS-P) Certified Coding Specialist - Physician
• (RHIT) Registered Health Information Technician
• (RHIA) Registered Health Information Administrator
• Any relevant certification not listed above but issued from a governing body listed below may be reviewed and considered by the business to satisfy this requirement
Additional Skills/ Specialized Training Required:
• Experience in coding hospital electronic medical records.
• Excellent communication and interpersonal skills.
• Experience with automated patient care and coding systems. (Cerner Electronic Health Record, OPTUM Enterprise Computer Assisted Coding, 3M encoder, Soarian financial billing system.)
• Competence with MS Office software (Word, Excel, Zoom and Outlook).
• Knowledge of American Healthcare Association ("AHA") coding clinic guidelines, ICD-10-CM and CPT coding guidelines, Center for Medicare & Medicaid Services ("CMS") guidelines, American Health Information Management Association ("AHIMA") and American Academy of Professional Coders ("AAPC") code of ethics.
💡 Quick Summary
Seeking a career-building opportunity? The HOSPITAL OUTPATIENT CODER position is now open for candidates interested in the Work from home Jobs sector. This role in Tampa offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Work from home Jobs is a plus.
