Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Under the general direction of the OP Coding Supervisor, the Outpatient Coder I is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in one complex outpatient coding service line. Work may include, but is not limited to: coding cases, prioritizing assigned coding tasks , resolving claim edits, handling individual coding workload, working stop bills (if assigned), and sending queries, as needed, to clinical staff.
EEO/AA/Disability/Veteran
Responsibilities
- Reviews medical record documentation to determine appropriate ICD-10-CM codes in accordance with official coding guidelines.
- Reviews medical record documentation and accurately selects the appropriate CPT codes, modifiers, and ICD-10-PCS, when applicable, in accordance with official coding guidelines.
- This includes resolving CCI edits, as applicable.
- Maintains a minimum of 95% overall coding quality score in diagnostic, procedural, and modifier code selection.
- Maintains the productivity expectations as defined by the department for the coding service line.
- Capable of coding a minimum of one complex OP service line, which would include: Cardiology, Interventional Radiology, Observation, Oncology, or Same Day Surgery at proficiency.
- Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions, and actively participates in learning circles.
- Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet CFB (candidate for billing) goals.
- Resolves cases returned coder for education and/or errors, and uses feed back to improve ongoing performance.
- Handles coding DNBs and stop bills (if assigned), or other projects and/or coding initiatives as assigned.
- Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures.
- Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and vision of the department.
Qualifications
- EDUCATION Bachelors degree preferred.
- Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process.
- EXPERIENCE Requires a minimum of 2 years of outpatient or professional coding experience in a complex service line.
- Coding experience may be partly substituted for a college degree with an RHIT/RHIA credential or CCS/CCS-P coding credential.
- Prior experience in Epic and 3M encoder is preferred.
- LICENSURE CCS, CCS-P, or RHIT credential preferred.
- Must possess a valid coding credential through AAPC and/or AHIMA.
- CPC-A or CCA not accepted.
- SPECIAL SKILLS Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM/PCS, and CPT coding with the ability to acclimate and apply knowledge in a fast-paced OP Coding department setting.
- Knowledge of professional E/M leveling preferred.
- Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills.
- Must be able to perform functions independently and under limited supervision.
YNHHS Requisition ID: 161127
