Medical Coding Specialist - Outpatient (full-time)

Sauk Prairie Healthcare; United States; Remote; USD 55.000 - 75.000; Vollzeit

Benefits dieser Stelle

Health and dental insurance

Flexible paid time off

Retirement plan with employer match

Fitness facility discount

Tuition reimbursement

Life and disability insurance

Free parking

Zusammenfassung

Sauk Prairie Healthcare is seeking a Medical Coding Specialist – Outpatient for 100% remote work with optional onsite in Wisconsin or Illinois. The role focuses on Emergency Department and Urgent Care coding, with responsibilities across outpatient facilities and physician documentation for claims.

Ideal candidates will have AHIMA/AAPC credentials or an related associate degree and ambulatory coding experience preferred. Remote work is available with residency requirements in WI or IL.

Qualifikationen

• AHIMA or AAPC credentialing within six months of hire
• Professional coding training or degree
• Ambulatory coding experience preferred

Aufgaben

• Assigns ICD/CPT codes for outpatient services for claims processing
• Audits EMR for accuracy of patient and insurance information
• Reviews NCCI and OCE edits and resolves issues
• Clarifies coding guidelines with clinical staff
• Identifies missed revenue opportunities and works with analysts
• Investigates denied claims and pursues timely appeals
• Abstracts information from patient records and queries physicians
• Participates in training and policy development for coding
• Attends continuing education and maintains coding credentials
• Performs other related coding tasks as required

Kenntnisse

ICD coding

CPT coding

Revenue cycle

EMR auditing

Coding guidelines

Ausbildung

AHIMA/AAPC course or Associate degree

Associate degree preferred

Tools

EMR systems

NCCI/OCE edits

Jobbeschreibung

Looking to be part of a team that provides extraordinary healthcare from the heart? You Belong Here.

100% Remote position with option to work onsite. Wisconsin or Illinois residency required

POSITION SPECIFICS

Title: Medical Coding Specialist – Outpatient

FTE: 1.0 (40 hours per week)

Schedule: Monday to Friday, five (5) 8-hour shifts between hours of 6am and 5pm

Holiday Rotation: None

Weekend Rotation: None

On Call Requirements: None

POSITION SUMMARY

Reviews medical reports and physician documentation for clinic and hospital outpatient services in order to apply diagnostic and procedural codes to individual patient health information for claims processing, data retrieval and analysis.

This role will primarily focus on Emergency Department and Urgent Care coding but will also assist in other areas.

POSITION TECHNICAL RESPONSIBILITIES

• Assigns codes for ambulatory outpatient services using International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding protocols, for facility and professional services. Includes professional code entry for Emergency Room and Urgent Care providers.
• Audits the electronic medical record for accuracy of patient information, insurance information, appropriate diagnosis, and procedure codes to ensure accurate documentation for billing and reimbursement.,
• Reviews and resolves National Correct Coding Initiatives (NCCI) and Outpatient Code Editor (OCE) edits.
• Communicates with clinical department directors and medical billing staff to clarify coding guidelines and resolve claim edits.
• Identifies and communicates missed revenue opportunities to ambulatory departments. Works with business analyst to create new charge codes, as needed.
• As assigned, investigates denied claims from insurance carriers and appeals timely to ensure accurate reimbursement.
• Abstracts pertinent information from patient records using hospital information system.
• Queries physicians as needed to provide clarification on documentation or code assignment.
• Identifies coding concerns or trends. As needed, involves Revenue Cycle leadership to assist with resolution.
• Provides education on coding changes.
• Attends continuing education programs and reviews other educational resources to keep current on any changes pertaining to this position and for coding re-certification.
• Assists with developing policies and procedures related to coding.
• Assists in training new employees and job shadowing.
• Performs other related work assignments as required.

POSITION REQUIREMENTS

Education:

• Required: Successful completion of a professional American Health Information Management (AHIMA) or American Academy of Professional Coders (AAPC) recognized coding course and/or an Associate degree in a healthcare related program.
• Preferred: Associates degree in a healthcare related program

Experience:

• Required: None
• Preferred: Prior Ambulatory Coding experience preferred.

Licenses and Registrations:

• Required: None
• Preferred: None

Certification(s):

• Required: Must obtain credentials through the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) in any of the following certifications within six months of date of hire and maintain such credential thereafter:

BENEFIT SUMMARY

• Competitive health and dental insurance options
• Flexible paid time off to balance work and life
• Retirement plan with immediate vesting and employer match
• Discounted membership to our state-of-the-art fitness facility
• Generous tuition reimbursement
• Employer provided life and disability insurance
• Free parking at facility

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