Health and Information Management - Outpatient Coder

Pinnacle Technology; Weatherford (TX); Remote; USD 85,000 - 110,000; Full time

Job summary

Pinnacle Technology seeks a Coding Specialist III to support Same Day Surgery/ED WQs, ensuring codes meet guidelines while maintaining PHI security. The role requires extensive hospital coding experience, RHIA/RHIT/CCS or CPC credentials, and EPIC/3M proficiency. A remote, VPN-enabled setup is expected.

Onboarding is part of the arrangement, with weekday CST hours. Strong internet and private workspace are mandatory to protect patient information and ensure accurate data abstraction.

Qualifications

• 3–5 years acute hospital-based coding experience.
• Remote work environment experience preferred; required for PRN Coders
• RHIA/RHIT/CCS, CPC, CPC-H or equivalent credentials required.

Responsibilities

• Code retrospective outpatient accounts using ICD-10-CM, CPT, HCPCS, and Modifiers per Official Coding Guidelines.
• Identify Reason for Visit, First Listed, and all Secondary Diagnoses and Procedures to support medical necessity.
• Validate charge-master driven CPT code assignments and route appropriately.
• Abstract required data elements including discharge dispositions, dates, physicians, and occurrence codes.
• Identify when physician queries are needed and follow up for documentation.
• Maintain the Quality Standards set by UTSW/HIM Coding.
• Maintain Productivity Standards set by UTSW/HIM Coding.
• Mentor/train on designated coding service lines as requested.
• Maintain expert knowledge of coding guidelines and practices.
• Other duties as assigned.

Skills

ICD-10-CM coding

CPT/HCPCS coding

EPIC EMR

3M 360 encoder

Remote work tools VPN

Attention to detail

Education

RHIA/RHIT/CCS or CPC/CPC-H

Health Information Management degree

Tools

EPIC EMR

3M 360 encoder

Job description

This contract position will help assist with keeping our Same Day Surgery and/or ED WQs within goal during the upcoming holidays. OP Surgery Coding team - Coding Specialist III Requirements RHIA, RHIT, CPC or CCS credential Facility coding experience is a must Day Surgery Coding Experience ED Coding Experience EPIC EMR and 3M 360 encoder Experience Must have reliable, high speed internet connection Must connect to the internet through VPN Must have a dedicated workspace that is quite and private due to PHI being accessed Will need to be available for onboarding 1 week - M-F 7:30 am - 4:30pm CST

ESSENTIAL FUNCTIONS

1. Responsible for coding retrospective outpatient accounts using ICD-10 CM, CPT, HCPCS, and Modifiers in compliance with the Official Coding Guidelines and conventions.
2. Accurately identifies most appropriate Reason for Visit, First Listed, and all Secondary Diagnosis as appropriate, and all Procedures as appropriate to support medical necessity and resolve LCD, NCD, and CCI edits.
3. Validates charge-master driven CPT code assignments and routes appropriately.
4. Accurately abstracts required data elements including, discharge disposition, procedure dates and physician(s), applicable occurrence codes, and other designated data.
5. a) Identifies when a physician query is appropriate for further clarification b) Recognizes when the documentation is missing or incomplete and routes appropriately c) Completes review and final coding when query and/or documentation is available
6. Maintain the Quality Standards set by UTSW/HIM Coding.
7. Maintain the Productivity Standards set by UTSW/HIM Coding.
8. Mentor/train on designated coding service lines as requested to ensure quality.
9. Maintains an expert level of knowledge of coding related guidelines and practices.
10. Other duties as assigned

MINIMUM QUALIFICATIONS

• Required three to five (3-5) years acute hospital based coding experience. An equivalent combination of education and experience may be considered. Experience working in a remote environment preferred; required for PRN Coders
• Requires an advanced level of computer skills and knowledge
• Preferred knowledge of 3M 360 and Epic.
• Preferred Bachelor's Degree or Associate Degree in Health Information Management and/or closely related field
• Required; Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), or AHIMA Certified Coding Specialist (CCS), AAPC Certified Outpatient Coder(COC), AAPC Certified Professional Coder (CPC)-Prior to 2014, or AAPC Certified Professional Coder-Hospital (CPC-H)