Coder II

Berger Health System; Kentucky; Hybrid; USD 55,000 - 75,000; Full time

Job summary

OhioHealth seeks a qualified medical coder to perform facility coding and abstracting for outpatient services including ED, diagnostics, and ambulatory areas. You will assign diagnoses and procedures, verify medical necessity, and support billing with accurate documentation and coding in multiple systems.

Qualifications include a high school diploma or GED and AHIMA/AAPC certifications (RHIA/RHIT). The role requires certification readiness within 6 months and strong adherence to coding

Qualifications

• Completion of a 2 year program and coding Certification from AHIMA or AAPC.
• Graduate of a HIM program with RHIA/RHIT certification.
• Demonstrated knowledge of ICD-9, ICD-10 and CPT-4 classification systems.
• Ability to sit for certification exam within 6 months of hire or program completion.

Responsibilities

• Assigns appropriate admit, reason for visit, principal and secondary ICD-9, ICD-10 and CPT-4 codes with 95% quality.
• Reviews records for diagnoses meeting medical necessity for procedures and hospital services.
• Determines CPT modifiers and supports clinic coding charges with appropriate E/M levels.
• Obtains clarifications from physicians when documentation is unclear for coding.
• Abstracts data elements for UB-04 and supports hospital reporting requirements.

Education

High School or GED

AAPC Certification

AHIMA Certification

RHIA Certification

RHIT Certification

Job description

Job Description Summary

This position performs facility coding and abstracting functions of outpatient cases including Emergency Department, Diagnostics, MSF and Recurring Patient type, Ambulatory Surgery, Observation, Outpatient in a Bed, and/or Clinic charging and coding of accounts.

Responsibilities And Duties

• 60% Assigns appropriate admit, reason for visit, principal and secondary ICD-9, ICD-10 and CPT- 4 diagnoses and/or procedures by reading documentation present in medical record and applying knowledge of correct coding guidelines as appropriate for hospital service and/or patient type while maintaining 95% quality and meeting and maintaining the minimum Coder productivity requirements. Assigns appropriate CPT Modifiers for facility coding to all CPT codes when necessary. Reviews records for diagnoses that meet medical necessity for Diagnostic and surgical procedures performed according to the CMS Local Coverage Determination LC d and/or National Coverage Determination NC d guidelines. Responsible for recognizing when it is necessary to obtain further clarification from physician when documentation is inadequate, ambiguous, or unclear for coding purposes. Responsible for accurate coding and charging of clinic accounts including the assignment of a facility E/M level using the Ohio Health Scorecard for guidance. Responsible for retrieval of documentation to support the coding of accounts that reside in non-HIM department source systems GE Gentricity, Mosaic, etc. . Assists educators and supervisors with reviewing accounts denied by RAC and other governmental payers for appropriate documentation to support original coding.
• 20% In the event of insufficient, missing or conflicting documentation, assigns transaction codes in HBOC system and follows department policy for follow up and physician query.
• 10% : Abstracts all data elements necessary to complete UB0 4 and meet hospital-reporting requirements.
• 5% : Verifies demographics, corrects account number, charges and service and identify missing or incorrect forms in each record.
• 5% : Identifies problem cases on the DNFB and forwards to appropriate staff for follow up.

The major duties, responsibilities and listed above are not intended to be all-inclusive of the duties, responsibilities and to be performed by employees in this job. Employee is expected to all perform other duties as requested by supervisor.

Minimum Qualifications

• High School or GED (Required)
• AAPC - American Academy of Professional Coders - AAPC American Academy of Professional Coders
• AHIMA - American Health Information Management Association - American Health Information Management Association
• RHIA - Registered Health Information Administrator - American Health Information Management Association
• RHIT - Registered Health Information Technician - American Health Information Management Association

Additional Job Description

Completion of a 2 year program and coding Certification from AHIMA or AAPC and/or graduate of a HIM program and Certification as RHIA/RHIT, and demonstrated knowledge of ICD-9, ICD-10 and CPT-4 classification systems, Advanced Anatomy & Physiology, Medical Terminology, ambulatory reimbursement schemes, and CMS Local Coverage Determination (LCD) and/or National Coverage Determination (NCD) guidelines. Must be eligible to sit for Certification exam within 6 months of hire or within 6 months of completion of the coding program, and pass the AAPC and/or AHIMA Certification exam.

Work Shift

Day Scheduled Weekly Hours : 40 Department Hospital Coding

Equal Employment Opportunity

OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment.

Remote Work Disclaimer

Positions marked as remote are only eligible for work from Ohio.

We Are Inspired to Do Our Best

OhioHealth is a nationally recognized, innovative healthcare system delivering world-class patient care in a supportive, professional environment filled with limitless opportunities to learn and grow. We are a unique organization in the healthcare field. Our model system of facilities encompasses a wide scope of expertise and care. For professionals, we are a place where people committed to doing their best are given the tools and resources to accomplish our mission every single day. OhioHealth is recognized as a Great Place to Work Certified organization. The Great Place to Work is a global authority on high-trust, high-performance workplace cultures. This recognition is one measure of our success in achieving a part of our vision to be an organization "where people want to work".

Join us!

If your passion is to work in a caring environment, if you believe that learning is a life-long process, if you strive for excellence and want to be among the best in the healthcare industry.