Job description

JOB DESCRIPTION

Job Title: Outpatient Coder

McPherson Hospital Mission: To meet our community’s needs by providing superior healthcare and exceptional service for each person, every time.

Job Summary: This position assigns diagnosis and procedures codes to patient accounts to ensure accurate and timely claims to be submitted to payers for reimbursement.

Department: Health Information Management

Reports to: Director of Health Information Management

Areas of Responsibility: Ancillary departments, Recurring and Referred.

Principal Accountabilities:

1. Completes ancillary department, recurring and referred coding functions utilizing approved system workflow applications for coding, abstracting, and financial billing.

2. Demonstrates the ability to achieve accurate, complete and consistent selection of principle and relevant secondary diagnosis; identifies signs and symptoms for medical necessity; and verifies and corrects admission source and discharge disposition codes (if hospital system requires).

3. Validate appropriateness of physician orders and signatures. Pend accounts for inappropriate orders and signatures.

4. Responds to billing edit queries from Patient Financial Services within departmental guidelines.

5. Follows American Hospital Association (AHA) Coding Guidelines and other regulatory agency directives for ICD, CPT, and HCPCS II coding.

6. Maintains current knowledge of coding issues by reading official coding guidelines such as AHA Coding Clinic, American Medical Association (AMA) CPT Assistant, WPS and CMS medical necessity regulations.

7. Meets productivity and accuracy requirements consistently per HIM policy.

8. Maintains professional certification as mandated by professional organizations (AHIMA, AAPC).

9. Assists HIM management in orientation and training of new staff and contract coders, as required.

10. Attend continuing education seminars via remote or on site as scheduled.

11. May perform other duties as assigned.

Qualifications:

Education/Experience:

1)Certified Professional Coder – Hospital (CPC-H) or equivalent certification required.

2) Associate’s degree or equivalent from two-year college preferably in Health Information Management, preferred.

3) One year of acute hospital coding experience, preferred.

Skills:

1) Knowledgeable in medical terminology, anatomy and physiology, disease processes, and procedural/surgical intervention. Understanding of ICD and CPT coding conventions.

2) Knowledge of computerized encoder and abstracting systems as well as coding guidelines.

3) Must be proficient in keyboarding skills.

4) Must possess the ability to learn software utilized on a daily basis.

Licensure/Certification:

1) Required: Certified Professional Coder – Hospital (CPC-H), or must be eligible to sit and successfully pass the CPC-H coding certification exam within 6 months of hire.

2) Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS), or must be eligible to sit and successfully pass one of the above-mentioned coding certification or professional credentials within 6 months of hire.

Age Specific Skills:

No age-specific skills required.

Hazardous Working Conditions:

No exposure to hazardous conditions.

Environmental Surroundings:

Located in a comfortable indoor area. Remote work available.

Physical Working Conditions:

Sitting in a comfortable position with frequent opportunity to move about.

I have read and understand my job description.

______________________________________ ___________________

Employee Signature Date

Job Type: Full-time

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: One location

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