Certified Surgical Coder

CO500 Nebraska Methodist Health System; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

Nebraska Methodist Health System is seeking an experienced Medical Coder to assign ICD-10-CM diagnoses and CPT/HCPCS codes for outpatient records. You will review charges, verify accuracy, and support timely claims submission.

Requires 3+ years coding physician services, CPC/COC/RHIT/CCA/CCS-P certifications, and a high school diploma with relevant education. Location: Omaha, NE; Mon-Fri, full-time daytime shifts.

Qualifications

• Education: High School Diploma or GED; college courses in anatomy/physiology recommended.

Responsibilities

• Assigns ICD-10-CM diagnosis and CPT procedure codes for outpatient records to ensure reimbursement.

Skills

Attention to detail

ICD-10-CM coding

CPT coding

Medical terminology

Auditing/claims review

Education

Associate's Degree in Health Information Management

CPC / COC / RHIT / CCA / CCS-P certification

High School Diploma or GED

Tools

Charge entry software

Charge viewer

CPT/HCPCS coding software

Job description

Why work for Nebraska Methodist Health System?

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary

Location: Methodist Corporate Office Address: 825 S 169th St. - Omaha, NE
Work Schedule: Mon - Fri, full-time, flexible 8-hour daytime shifts

Codes professional charges for surgical procedures for inpatient and outpatient services including correct CPT, ICD-10-CM, and modifiers in accordance with medical policies and guidelines.

Responsibilities

• Assigns ICD-10-CM diagnosis, Current Procedural Terminology (CPT) procedure codes, and Healthcare Common Procedure Coding System (HCPCS) device codes as necessary to outpatient records to ensure maximum reimbursement, utilizing ICD-10-CM and Current Procedural Terminology (CPT) principles of code assignment and Uniforms Hospital Discharge Data Set (UHDDS) definitions of principle and secondary diagnosis. Accuracy rate of at least 95%.
• Enters ICD-10-CM diagnosis code(s) and Current Procedural Terminology (CPT) procedure code(s) into the code summary to maintain disease and operation index, to allow for timely submission of claims to insurance companies by assigning correct diagnosis and procedure codes and the reason for the encounter per department procedure. Accuracy rate of at least 95%.
• Reviews Current Procedural Terminology (CPT) procedure codes and Healthcare Common Procedure Coding System (HCPCS) device codes in the code summary and charge viewer to ensure all accounts reflect appropriate charges for services and devices provided; by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account.
• Reviews hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates.
• Reviews coding with Physician 95% of the time. Per provider request. Per departmental audit standards.
• Investigates claim denials from third party payers to ensure accuracy by reviewing services patient received and patient account and making any coding/charging corrections. Per department process regarding code reviews within 14 days of receipt. Per request from clinic personnel. Per request from Business Office and/or Customer Service Personnel.
• Ensures timely submission of claims to insurance companies by performing job functions #1 by maintaining Accounts Receivable within 3 days of discharge on all outpatient encounters.
• Maintains a minimum productivity standard of:
  Codes 7 OPS encounters per hour.
  Codes 5 OBS encounters per hour.
  Codes 12 Infusion Center encounters per hour.
  Codes 10 GI/Pain Management encounters per hour.
  Codes 30 Radiology/OP Diagnostic services encounters per hour.
  Codes 15 Recurring encounters per hour.
  Codes 30 Radiology/OP Diagnostic services encounters per hour.
  Codes 25 Non-patient Pathology Encounters per hour.
  Codes 15 Emergency Department encounters per hour.
  Codes 12 Professional Services encounters per hour.
• Utilizes and understands how to view and make appropriate changes in charge viewer to ensure maximum reimbursement.

Job Requirements

• Education: High School Diploma or General Educational Development (G.E.D) required. College level completion of courses in anatomy and physiology, biology, disease process, and medical terminology required. Associate's Degree in Health Information Management or healthcare related degree preferred. Participates in mandatory in-services and continuing education as mandated by policies and procedures, external agencies, and as directed by supervisor.
• Experience: 3+ years previous experience coding physician services from documentation preferred, surgical and Evaluation/Management (E/M) required.
• License/Certifications: Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Registered Health Information Tech (RHIT) or certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) required.

Skills/Knowledge/Abilities

• Ability to note detail when reviewing the medical record, verifying the diagnosis and reviewing charges at the time of ICD-10-CM and Current Procedural Terminology (C PT) code assignment.
• Understanding of outpatient prospective payment methodology, and knowledge of the national correct coding initiatives.
• Skills necessary to operate a personal computer and Microsoft Office programs. Experience with personal computer and knowledge of Word, Excel, etc.

Physical Requirements

• Weight Demands Light Work - Exerting up to 20 pounds of force.
• Physical Activity Not necessary for the position (0%): Climbing Crawling Kneeling Occasionally Performed (1%-33%): Balancing Carrying Crouching Distinguish colors Lifting Pulling/Pushing Standing Stooping/bending Twisting Walking Frequently Performed (34%-66%): Grasping Reaching Repetitive Motions Sitting Speaking/talking Constantly Performed (67%-100%): Fingering/Touching Hearing Keyboarding/typing Seeing/Visual

Job Hazards

• Not Related: Chemical agents (Toxic, Corrosive, Flammable, Latex) Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF) Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)

Equipment/Machinery/Tools

• Explosives (pressurized gas) Electrical Shock/Static Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc) Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means) Mechanical moving parts/vibrations

About Methodist

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affire affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.

At Methodist Health System, we focus on providing exceptional care to the communities we serve and the people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. If you join our organization, you will have the opportunity to excel in your field, use the latest technologies, learn from the best and work as a team. You’ll have the opportunity to make a difference through The Meaning of Care.