Position Description

Under the supervision of the HIS OP Coding Reimbursement/Coordination, the Coder II is responsible for reviewing the medical record in its entirety, apply coding guidelines and regulations and assign ICD-CM and/or PCS and CPT diagnoses and procedures codes accurately and timely. Consistently meet/exceed turnaround times and quality expectations.

 

PRIMARY DUTIES AND RESPONSIBILITIES

Reviews records and assigns codes for diagnosis and procedures according to policy and procedures and official coding guidelines for OBV, ER and SDS patient type and complex injections and infusions. Abstracts required information from the record and enters into abstracting system. Queries physicians for additional documentation to ensure appropriate reimbursement and/or acuity of patient’s account. Ensures optimal reimbursement for outpatient accounts through accurate CPT code assignment and modifier placement. Understands and applies LMRP/NCD/LCD guidelines to meet medical necessity for outpatient accounts. Reviews and resolves NCCI/OCE edits on outpatient claims. Maintains current coding knowledge through self-motivated education and hospital resources.

Position Requirements

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED:

High School diploma or equivalent required. Minimum one years’ experience in acute healthcare setting, preferred. Coding credentials, i.e. CCS, COC, CCS-P, CPC, RHIT, and RHIA required. Working knowledge of healthcare revenue cycle functions, including documentation, coding and billing guidelines preferred. Ability to accurately apply ICD-10 diagnosis, procedures and CPT/HCPCs procedure codes preferred. Thorough knowledge of medical terminology, anatomy and physiology, and pharmacology required. Ability to use computers effectively. Excellent communication skills, including written and oral, teaching and presentation skills required. Knowledge of EMR (Cerner, EPIC) Knowledge or various encoders (Optum, Clintegrity, Compliance 360 and 3M), to include knowledge of CAC system.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION PREFERRED:

Credentials from AHIMA or AAPC Three + years coding experience in multispecialty Three (3) to five (5) years’ experience in Acute Care, CPT-ICD-10-CM codes. Previous experience with compliance software. Previous imaging system and/or HBOC products. 

Service Area Overview