Outpatient Coding Specialist

Position Summary

Under the general direction of the Coding Compliance Manager the Outpatient Coding Specialist is responsible for coding and abstracting services for the full range of hospital services. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or surgical procedures outpatient services, and/or emergency room records using ICD 10 CM and CPT 4 coding classification systems. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding.

Location:

West Center Street, West Bridgewater, MA

Department:
Health Informatic

This is a full-time 40 hour/ week position

• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
• Commits to recognize and respect cultural diversity for all customers (internal and external).
• Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed.
• Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements.
• Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate assignments of ICD 10-CM and CPT codes and reconciliation of charges.
• Assigned codes are compliant with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS) Office of the Inspector General (OIG) and Health Care Financing Administration(HCFA), as well as Signature Healthcare and applicable professional standards.
• Query responsible provider when further documentation or clarification is needed, ensures timely response.
• Performs other duties as assigned

• Must be able to demonstrate advanced knowledge of ICD 10 and/or CPT coding and abstracting skills.
• Must score a minimum of 85% on a pre-employment coding test.
• Must be able to demonstrate knowledge of reimbursement (Medicare and Medicaid) principles.
• Must have knowledge medical terminology, the human disease process, anatomy and physiology.
• Must be able to demonstrate good organizational skills.
• Must be able to effectively communicate, both orally and in writing.
• Must be able to demonstrate knowledge of computer software applications including MS office.

• Education:
  
  Must have successfully completed an approved coding program OR;
  Must be a graduate of a Health Information Management program
• Experience:
  
  Must have 3 years of coding experience in an acute care hospital environment. Experience must be specific to the area of placement i.e. inpatient/outpatient coding
• Certification/Licensure:
  Requires Certified Coding Specialists (CCS) or Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT) or Registered Health Information Administration (RHIA)
• Software/Hardware: 3M encoder
• Other: EMR