Outpatient Coder

Departments

  • Health Information Management
  • North Star Recovery

Work Hours

  • 80 Hours
  • Full Time

Categories

  • Administrative / Clerical

Job Summary

The Outpatient Coder is responsible for coding Emergency Room recordsĀ for reimbursement, research and compliance purposes.

Qualifications

  • Education
    • High School Diploma required
    • RHIA, CCS, CPC, CHA, or CPMA preferred
    • Knowledge of ICD and CPT codes, medical record practices, and abstracting.
  • Training and Experience
    • 2 years experience in coding

Essential Functions

  • Coding
    • Code Outpatient records for the purpose of reimbursement, research, internal retrieval needs and compliance with federal regulations according to diagnosis(es), operation(s), using the ICD codes, plus the HCPS code system.
    • Enter all data into computer from inpatient documentation and the patient super bill.
  • Point of Contact/Liaison
    • Serve as a resource to in-house hospital staff, PFS, Physician Coding, and other departments involved in the process of Coding and Billing for Inpatients.
    • Resolve issues between Inpatient and ancillary offices and administrative/billing areas in order to optimize reimbursement.
    • Oversee inpatient coding to ensure daily procedures function efficiently.
    • Identify process improvement initiatives related to coding and charging of inpatient services.
  • Education
    • Training and education of staff and providers on coding processes and compliance.
    • Provide or coordinate education sessions on billing processes, coding compliance issues, and other areas that affect the reimbursement of inpatient charges.
    • Work closely with HIM to facilitate comprehensive medical record documentation to reflect clinical treatment, decisions, and diagnoses for patients.
    • Maintain current knowledge of optimum coding practice by reviewing newsletters, attending seminars, developing 3rd party contacts, etc.
  • Auditing
    • Developing coding and billing audit plans and ensuring timely completion of coding and billing audits and dissemination of audit findings.
    • Perform various internal coding/reimbursement audits, analyze data, and recommend any necessary changes.
    • Identify inpatient services provided, but not adequately documented in the medical record.
    • Analyze and resolve inpatient claim rejections and denials from the billing system or insurance carriers related to coding issues.
    • Develop and maintain effective tools and methodologies to appropriately monitor coding and billing compliance.
    • Identify trends/problems in medical documentation and recommend possible solutions.
  • Statistics
    • Compiling monthly/quarterly reports as requested/required.

Status

  • Monday-Friday
  • 8:30 A.M.-5:00 P.M.
  • Overtime Possible