Coder II - Anatomic Pathology

Aurora Health Care; Allenton (WI); On-site; USD 55,000 - 75,000; Full time

Job summary

Aurora Health Care is seeking a hospital-based coder to accurately code professional services for outpatient and inpatient encounters. You will review medical records, assign diagnoses, CPT codes, and modifiers in alignment with Teaching Physician rules.

Maintain current knowledge of ICD/CPT, participate in continuing education, and support colleagues with coding and billing matters. The role includes physician education and resolving coding denials.

Qualifications

• Two years medical coding experience in a hospital/teaching environment.
• Eligible for internal promotion based on performance criteria after six months.
• Active coding certification (AAPC or AHIMA) required.
• High school diploma or GED required.

Responsibilities

• Code hospital-based professional services (outpatient/inpatient) with appropriate diagnoses, CPT codes, and modifiers.
• Keep current with ICD, CPT, and regulatory coding changes; attend relevant trainings.
• Maintain continuing education hours for certification.
• Serve as a resource for less experienced coders within the team.
• Collaborate with Revenue Cycle and Compliance Analysts on documentation, coding and billing issues.
• Educate physicians to ensure documentation supports accurate coding.
• Resolve pending charges in coding work queues and denial queues.
• Perform related duties as needed.

Skills

Medical coding

Coding certification

Teaching environment experience

Medicare familiarity

Physician teaching rules

Provider-based clinic billing

Quality & productivity standards

Education

High school diploma or GED

AAPC or AHIMA certification

Job description

• Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading and/or reviewing medical record documentation to assign and sequence diagnoses and procedure codes according to coding guidelines, and enter into the electronic system: a. Appropriate diagnoses codes, professional service codes and modifiers and/or facility service/ charge codes. b. Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules.
• Maintains a current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for unlisted or unusual CPT codes), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures.
• Accrues sufficient continuing education hours to maintain national coding certification.
• Serves as a resource for less experienced medical coders.
• Works collaboratively with team members, Corporate Revenue Cycle, and Compliance Analysts to answer questions and/or resolve issues related to documentation, coding and billing of professional services and/or facility services.
• Provides physician education to ensure documentation is sufficient for greatest accuracy of coding.
• Resolves pending charges in the WakeOne coding work queues including claim denial work queues.
• Performs other related duties incidental to the work described herein.

• Responsible for timely and accurate coding of hospital based professional services (outpatient hospital or inpatient hospital; single services or complete inpatient stays) by reading and/or reviewing medical record documentation to assign and sequence diagnoses and procedure codes according to coding guidelines, and enter into the electronic system: a. Appropriate diagnoses codes, professional service codes and modifiers and/or facility service/ charge codes. b. Assign and record appropriate modifiers (i.e., GC, NO or NDU) as appropriate based on Teaching Physician rules.
• Maintains a current knowledge of ICD diagnosis codes, CPT physician service codes, internal codes (for unlisted or unusual CPT codes), and governmental (Medicare, Medicaid, TriCare), commercial and managed care regulations by reading relevant professional literature and by attending workshops and lectures.
• Accrues sufficient continuing education hours to maintain national coding certification.
• Serves as a resource for less experienced medical coders.
• Works collaboratively with team members, Corporate Revenue Cycle, and Compliance Analysts to answer questions and/or resolve issues related to documentation, coding and billing of professional services and/or facility services.
• Provides physician education to ensure documentation is sufficient for greatest accuracy of coding.
• Resolves pending charges in the WakeOne coding work queues including claim denial work queues.
• Performs other related duties incidental to the work described herein.

Education/Experience

• Two (2) years of medical coding experience in a similar environment, or
• Eligibility for internal promotion based on achieving and maintaining Coder level II performance criteria by department for six consecutive months.
• High school diploma or GED equivalent

LICENSURE, CERTIFICATION, And/or REGISTRATION

• An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA)

Skills/Qualifications

• Experience in coding of physician professional services in a teaching environment
• Familiarity with Medicare
• Teaching Physician Rules
• Familiarity with facility fee services within a Provider Based clinic
• Ability to meet and maintain performance standards of quality and productivity for Level II Coder by department

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

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