Medicine Coder (Coding Specialist ll)

Oregon Health & Science University; Portland (OR); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated coding professional to join their Enterprise Coding Department. This role involves reviewing clinical documentation, ensuring compliance with coding standards, and applying the correct codes for various medical services. The ideal candidate will possess a strong background in ICD-10-CM and CPT coding, along with relevant certifications. You'll play a crucial role in supporting accurate billing processes while collaborating with a team of experts. This position offers the flexibility of telecommuting, allowing you to balance your professional and personal life effectively. If you're passionate about coding and eager to contribute to a dynamic team, this opportunity is perfect for you.

Benefits

Comprehensive health care plans

$25K term life insurance

Vacation up to 200 hours per year

Sick Leave - 96 hours per year

8 paid holidays per year

Tuition Reimbursement

Innovative Employee Assistance Program (EAP)

Qualifications

• Minimum two years of experience in coding medical records using ICD-10-CM and CPT.
• Certification in coding from AAPC or AHIMA required.

Responsibilities

• Review clinical documentation and assign correct coding for services.
• Ensure compliance with Medicare and Medicaid billing regulations.

Skills

ICD-10-CM coding

CPT coding

medical record reviewing

communication skills

Education

High School diploma or GED

Coding certification (AAPC or AHIMA)

Tools

EPIC

3M encoder

Microsoft Excel

Job description

Department Overview

This level 2 coding position provides support to the Enterprise Coding Department for coding of physician’s fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA.

• For Professional Services coding positions: This position is responsible for reviewing clinical documentation and applying the correct coding and modifiers to evaluation and management services and non-surgical procedural services. This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is in compliance with Medicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentation and CMS coding guidelines.

• For Facility Services coding positions: This position is responsible for reviewing documentation of outpatient diagnostic and ancillary services for diagnostic radiology, pathology, and other ancillary facility services at OHSU. This position provides support to the Enterprise Coding Department for abstracting of records, coding, and charge router submission of Facility services rendered at OHSU.

• Responsible for meeting performance standards set for accurate and timely submission of charges and coding for professional and facility services rendered at OHSU.

• Working in collaboration with Enterprise Coding Leadership and billing departments, provide technical expertise regarding a broad range of third party payer and reimbursement issues.

• Orient peer coders or new hires to specified coding assignments.

• Requires maintaining an hourly productivity standard and quality standards as set by Enterprise Coding and based on Industry Standards.

• Will require attendance of Enterprise Coding and Clinical Department meetings via conference call and WebEx.

• Coding Work Queue assignment will vary based on business needs or management assignment.

Function/Duties of Position

Coding:

• Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS).
• Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry.
• Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU.
• Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
• Coordinate all billing information and ensure that all information is complete and accurate.
• Ability to maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
• Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orientate, and mentor coding staff as necessary.

Department support:

• Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
• Attends coding meetings and seminars and shares knowledge with other coders. Participates in EC Huddles.
• In collaboration with Enterprise Coding Leadership, develop and disseminate written procedures to facilitate and improve billing and documentation processes.
• In collaboration with Leadership, make recommendations and implement remedial actions for problems.
• Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in CPT, ICD-10-CM, and HCPCS.
• Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, stay informed of current trends in coding.

Perform other duties as assigned.

Required Qualifications

• High School diploma or GED.
• Minimum two years of hospital or professional services (dependent on position) experience reviewing, abstracting, and coding medical records using ICD-10-CM and CPT coding.
• Certification in one of the following (as indicated by the position description):
  • Coding certification from AAPC or AHIMA:
  • Registered Health Information Administrator (RHIA),
  • Registered Health Information Technician (RHIT),
  • Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA). Active AHIMA membership may be required for some positions.
  • Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR equivalent certification.

Preferred Qualifications

• Accredited Coding Program required: AAPC Boot Camp, AHIMA Coding Boot Camp.
• Knowledge of OPPS guidelines and both CPT Inpatient and Outpatient coding guidelines, CCI edits and familiarity with medical necessity guidelines, NCD and LCD requirements.
• Experience using an EMR.
• Knowledge of CPT Outpatient coding guidelines, CCI edits and familiarity with medical necessity guidelines.
• Experience using EPIC, 3M encoder.
• Knowledge of CPT, ICD-10-CM, HCPCS, Federal Register, Federal and State insurance billing laws and Mandates.
• Proficiency with word processing and Excel spreadsheets.
• Excellent verbal and written communication skills with the ability to effectively communicate with individuals at all levels, physicians, nurses, administrative management, etc.
• Member of the American Academy of Professional Coders and Certified Professional Coder or AHIMA certification required upon hire.
• Able to pass internal coding test.

Additional Details

Department Core hours are: Monday - Friday, 5:00am - 10:00pm (with some flexibility available). Regularly scheduled work hours are required and are allowed within the Core Hours. Could include rotating weekend days.

This position is a telecommuting position.

Benefits:

• Comprehensive health care plans. Covered 100% for full-time employees and 88% for dependents.
• $25K of term life insurance provided at no cost to the employee.
• Two separate above market pension plans to choose from.
• Vacation - up to 200 hours per year depending on length of service, prorated for part-time.
• Sick Leave - 96 hours per year, prorated for part-time.
• 8 paid holidays per year.
• Substantial Tri-met and C-Tran discounts.
• Tuition Reimbursement.
• Innovative Employee Assistance Program (EAP).

All are welcome

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or [e-mail].