Medical Coding Specialist - Outpatient (full-time)

Sauk Prairie Healthcare, Inc.; Wisconsin; Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Retirement plan

Fitness facility

Tuition reimbursement

Life and disability insurance

Free parking

Job summary

Sauk Prairie Healthcare, Inc. is seeking a Medical Coding Specialist – Outpatient to review medical reports and apply diagnostic and procedural codes for ambulatory services, primarily ED and Urgent Care. This remote role offers the option to work onsite and requires Wisconsin or Illinois residency.

The position involves auditing records, collaborating with clinical departments, and staying current with coding changes. AHIMA/AAPC credentials must be obtained within six months of hire.

Qualifications

• Successful completion of AHIMA or AAPC coding education or an Associate degree.
• Preferred: Associates degree in healthcare-related field.
• Certification through AHIMA or AAPC within six months of hire.
• Ambulatory coding experience preferred.

Responsibilities

• Assigns outpatient codes (ICD and CPT) for facility and professional services.
• Audits EMR for accuracy of patient data and coding compliance.
• Clarifies coding guidelines with clinical departments and staff.
• Investigates denied claims and supports appeals as needed.
• Abstracts information from patient records using hospital information systems.

Skills

ICD/CPT coding

Auditing EMR

Communication with departments

Coding education

Education

AHIMA/AAPC coding course or associate degree

Associates degree in healthcare

Tools

EMR/HIS

Job description

Position Overview

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.

Title

Medical Coding Specialist – Outpatient

Position Specs

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.

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.
• Education: Preferred: Associates degree in a healthcare related program.
• Experience: Required: None.
• Experience: Preferred: Prior Ambulatory Coding experience preferred.
• Licenses and Registrations: Required: None.
• Licenses and Registrations: 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: Registered Health Information Technician (RHIT) or Administrator (RHIA) Certified Coding Associate (CCA) Certified Coding Specialist (CCS) Certified Professional Coder – Hospital (CPC-H) Certified Professional Coder (CPC) Certified Inpatient Coder (CIC) Certified Outpatient Coder (COC).

Benefits 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 #IND100

Company Culture

When you choose a career at Sauk Prairie Healthcare, you will enjoy a respectful, collaborative work environment where patient safety and quality are our highest priorities. Whether you’re seeking a job in nursing, medical imaging or another clinical field, or looking to bring your experience and excellent work ethic to one of the many non-clinical roles on our team, you’ll feel like You Belong Here.