Position Summary
The Ambulatory/Day Surgery/Observation coder shall review hospital outpatient medical documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT, HCPCS codes with outpatient encounters to ensure proper coding, billing, and compliance.
Key Responsibilities
- Reviews encounters to assign and sequence appropriate diagnoses and procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.
- Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity.
- Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.
- Reviews all appropriate work queues daily to address edits and make corrections coding procedures.
- Routes to billing charge entry errors and/ or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections when advised and follows procedure to notify billing.
- Adjusts and adapts to continual changes in the coding field. Practices ethical coding per AHIMA Standards of Ethical Coding.
- Meets and maintains HIM coding quality and productivity standards. Submits daily productivity report to coding manager by defined deadline.
- Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements.
- Enhances and maintains coding knowledge and skills
- Ability to perform coding across multiple locations based on corporate management need
- Technology skills to adapt to multiple applications used within the organization
- Candidate must display a superior knowledge of Coding Guidelines (Coding Clinic, UHDDS Official Coding Guidelines, CCI Edits).
- Ability to maintain 95% or greater accuracy rate
- Knowledge of physician query in an outpatient setting
- Candidate must have experience with 3M and/or 3M360 encompass
- Candidate must be self-motivated, display a high level of computer literacy, excellent verbal, and written communication skills, able to meet assigned deadlines, and organized
- The position will report to the HIM Outpatient Coding Manager
Required Knowledge & Skills
(Examples: Ability to work independently and take initiative; Good judgment and problem-solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)
- Minimum 2 years in Ambulatory Surgery Coding
- Comprehensive understanding of UHDDS guidelines, CCI Edits, Coding Clinic, etc.
- Meditech experience required
- Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint)
- Excellent verbal and written communication skills
- Ability to meet assigned deadlines.
Education/Experience/Licensure/Technical/Other
I. Education: Associate degree preferred
II. Experience: 3 years of Outpatient and Emergency Room coding in acute care setting.
III. Certification/Licensure: CCS and/or CPC certification
IV. Software/Hardware: 3M experienced required, Meditech experience preferred
V. Other: Remote position
About Steward Health Care
Over a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country's largest physician-led, minority-owned, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Based in Dallas, Steward currently operates more than 30 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, and Texas.
For more information, visit steward.org
