Utilizes appropriate coding guidelines to assign ICD and CPT codes; conforms to applicable Medicare, Medicaid and other third party payer guidelines to ensure receipt of accurate reimbursement. Accurately codes diagnoses, procedures and demographic information in the Health Information abstracting system. Codes and abstracts Ancillary, Observation, Emergency Dept. and Surgical Outpatient encounters.
· 3 to 5 years of directly related experience
· High School Diploma or GED
· RHIT, CCS, CPC, CIC, or other approved coding credential (must maintain current certification)
· Completion of AHIMA/AAPC coding program preferred
· Minimum of 2 years of experience coding clinical outpatient, Emergency
Department and Surgical Outpatient visits in a hospital setting or a Specialty
1. Applies broad guidelines to specific coding situations, independently utilizing discretion and analytic ability.
2. Communicates effectively verbally and in writing.
3. Demonstrate proficiency in ICD 10 CM and CPT coding classification systems, diagnosis and procedure selection, and sequencing guidelines and the APC system.
4. Maintains coding productivity and accuracy standards as established by the Coding Department.
5. Researches, analyzes, and re-codes national medical necessity (NCD) denials and local medical review (LMRP) denials for Medicare patients as appropriate for resubmission.
6. Abstracts and enters all codes and required demographic information into the appropriate computer systems and forms.
7. Assist other coders with resolving claims denied due to edits and updating the patient abstract from the ignored edit reports and coders mailbox monitoring.
8. Works independently and as a team member.
9. Performs audits and other duties as assigned.
10. Preserves confidential, protected health and personally identifiable information.