Job Description

Seeking a detailoriented coder who resides in either Washington or Oregon to assign diagnosis accurately and procedure codes for various healthcare settings including Emergency Department Ambulatory Surgical Center Hospital Ambulatory Surgical Center Observations and Inpatient records. Must maintain high standards of quality and productivity. Ability to communicate effectively with physicians for clarification and understand clinical content for data abstraction.

• Assign accurate diagnosis and procedure codes to patient health records for various facility settings
  
• Maintain acceptable levels of quality and productivity in ICD10CM ICD10PCS and HCPCS/CPT coding systems.
  
• Adhere to coding guidelines established by CMS NCHS AMA NCCI UHDDS OMAP
  
• Communicate with physicians to clarify diagnoses and procedures as needed.
  
• Abstract clinical data from health records and perform other assigned duties.
  
• Onsite training is required for one (1) week or until department expectations are met.
  

Responsibilities:

• Review medical records and assign appropriate codes for diagnoses procedures and services rendered.
  
• Validate Computer Assisted Coded (CAC) assignments for accuracy.
  
• Utilize Code Base Charge Trigger system (CBCT) and EncoderPRO software for coding professional surgical services.
  
• Abstract clinical data elements and ensure accurate sequencing of diagnosis and procedure codes.
  
• Perform chart analysis to identify incomplete or inaccurate documentation.
  
• Maintain department standards for productivity and quality.
  
• Stay updated on coding guidelines and regulations.
  

Qualifications:

• Candidates must reside either in Washington or Oregon to be considered.
  
• Minimum five (5) years experience in coding with four (4) years inpatient facility coding Advanced knowledge of medical terminology pharmacology and medial coding principles for ICD10CM ICD10PCS HCPCS/CPT and coding.
  
• Advance knowledge of disease processes diagnostic and surgical procedures ICD10CM ICD10PCS HCPCS/CPT classification systems health information/medical record department responsibilities with knowledge of government regulations and areas of scrutiny for potential fraud and abuse issues.
  
• Must reside either in Washington or Oregon
  

Additional Requirements

• Previous experience with EMR patient documentation systems with intermediate knowledge and skill in the use of a computer.
  
• Fluent in English demonstrating skill and proficiency in oral and written communication.
  
• Time management organization and analytical skills.
  
• Ability to manage a significant workload and to work efficiently under pressure meeting established deadlines with minimal supervision.
  
• Abides by the Standards of Ethical Coding as set for by the American Health Information Management Association (AHIMA).
  
• Pass a coding skill test with a 75% or better.
  
• Academic knowledge and working experience performing coding and abstracting responsibilities in health information/medical record services.
  
• The position requires the new coder to be onsite for one (1) week of training or until they meet the departments expectations.

Preferred Qualifications:

• Minimum five (5) years of experience in health information/Medical record environment with facility coding experience that includes Medicare reimbursement guidelines.
  
• Degree in Health Information Management.
  
• Proficient knowledge and skill in the use of a computer and related system and software to include: EMR(s) Microsoft Office Suite and other software programs.
  
• Ability to evaluate analyze and develop information regarding mathematical statistics and percentages that compare finding trends and outcomes related to productivity and /ore medical record audits.
  
• Extensive knowledge of ICD10 coding guidelines; with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements.
  

Education

• High School Diploma or General Education Development (GED) is required.

License Certification Registration

Must have 1 from the following list:

• Registered Health Information Technician Certificate
  
• Coding Specialist Certificate
  
• Registered Health Information Administrator Certificate

Minimum five (5) years experience in coding with four (4) years inpatient facility coding The candidate must have 1 from the following list: Registered Health Information Technician Certificate Certified Coding Specialist Registered Health Information Administrator Certificate Advanced knowledge of medical terminology pharmacology and medial coding principles for ICD10CM ICD10PCS HCPCS/CPT and coding. Advance knowledge of disease processes diagnostic and surgical procedures ICD10CM ICD10PCS HCPCS/CPT classification systems health information/medical record department responsibilities with knowledge of government regulations and areas of scrutiny for potential fraud and abuse issues

Remote Work :

No

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