Outpatient Coder II
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AI Summary
Accurately codes and abstracts outpatient medical records using ICD-10-CM and CPT-4 guidelines for reimbursement and statistical purposes. Responsibilities include reconciling charges, initiating physician queries for ambiguous documentation, and maintaining a minimum accuracy rate of 95%.
MUST RESIDE IN BELOW STATES: NY, CT, AL, AZ, CO, DE, FL, GA, IL, IN KS, MA, MD, ME, MI, MS, NC, NH, NJ, OH, OK, PA, SC, TN, TX, VA, WV
At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your care
Summary:
Accurately codes and abstracts outpatient medical records for reimbursement and statistical purposes using established coding guidelines. Reviews coding and amends coding edits to assure compliance with all applicable regulations.
Responsibilities:
- Codes all outpatient medical records in a timely and accurate manner according to department policy.
- Defines and transforms verbal descriptions of diseases, injuries, and procedures into numerical designations (codes) using ICD-10-CM and CPT-4 according to established coding guidelines.
- Initiates a physician/department query when there is conflicting, incomplete, or ambiguous documentation in the record or additional information is needed for accurate coding.
- Enters all required information accurately into computer system for reimbursement and statistical purposes.
- As applicable based on facility workflow, independently reconcile charges for areas of responsibility. Uses patient schedule together with billing slips to identify missing charges. researches and resolves discrepancy so charge keyed reflect services delivered.
- Performs ICD-10-CM diagnostic and CPT-4 coding at a minimum accuracy rate of 95%.
- Remains abreast of all applicable Federal, State, regulatory and hospital-specific coding guidelines.
- Applies applicable guidelines to all cases coded to ensure accuracy of selected codes.
- Accesses and research applicable reference materials to further support decision-making in code selection.
- Participates in Performance Improvement/Quality Assurance activities.
- Reports on software and hardware problems.
- Attends required educational sessions (webinars, conferences etc.) to maintain and enhance coding certification(s)
- Maintains and Model the Organization values.
- Demonstrates regular, reliable and predictable attendance.
- Performs other duties as required.
Minimum Knowledge, Skills, and Abilities Requirements:
Basic familiarity with MS Office applications (Word, Excel. Outlook)
Usage of coding manuals and regulatory websites for research
CPC, CPC-H, CCS, CCS-P, RHIA, RHIT, or specialty certification required.
Working Conditions:
Manual: Little or no manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health
Org Unit: 2069
Department: CODERS - PROFESSIONAL & FACILITY CHARGING and CODING
Exempt: No
Salary Range: $26.48 - $50.49 Hourly
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