The role involves reviewing medical record documentation to assign complex ICD-10 CM and CPT codes for outpatient encounters to ensure accurate coding, billing, and compliance. Responsibilities include correcting coding errors, reviewing chargemaster codes, maintaining coding knowledge, and adhering to strict patient confidentiality standards.
Location: Miramar, Florida
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.
Enhances and maintains coding knowledge and skills for physician billing. Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements.
Communicates with insurance companies about coding errors and disputes for physician billing. Reviews and validates accuracy of data in Admission-Discharge-Transfer (ADT) fields following HIM coding policies and procedures. Reviews CRW (Certified Social Worker) documentation to assign correct discharge disposition, notify coding management when clarification needed.
Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements.
Adjusts and adapts to continual changes in the coding field. Practices ethical coding per AHIMA Standards of Ethical Coding. Meets and maintains HIM coding quality and productivity standards. Submits daily productivity report to HIM manager by defined deadline.
Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.
Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures. Conducts, audits and/or coding reviews with various health care professionals to ensure all documentation is accurate for physician billing.
Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Create electronic physicians queries within allowed scope for hospital outpatient coder.
Accountability, accuracy - Coder, accuracy - Outpatient, analysis and decision making, customer service, effective communication, health information management (Him) systems - Coder, health information mngmt, medical record coding, medical terminology (1), productivity - Op coding, responding to change, standards of behavior
High School Diploma or Equivalent (Required)Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - State of Florida (FL), Registered Health Information Technician (RHIT AHIMA) - American Health Information Management Association (AHIMA)
Primarily for office workers - not eligible for shift differential
This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.
Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net [TalentAcquisitionCenter@mhs.net]
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