Outpatient Coder

Siri InfoSolutions, Inc.; United States; Remote; USD 55,000 - 83,000; Full time

Job summary

Siri InfoSolutions, Inc. seeks an experienced medical coder to perform retrospective outpatient coding using ICD-10-CM, CPT/HCPCS, and modifiers in a fast-paced clinic setting.

Role requires hospital-based coding background, attention to medical necessity, and ability to mentor others while maintaining coding guidelines and productivity standards.

Qualifications

• 3–5 years acute hospital-based coding experience.
• Remote environment experience preferred; required for PRN Coders.
• Knowledge of 3M 360 and Epic preferred.

Responsibilities

• Code retrospective outpatient accounts using ICD-10-CM, CPT, HCPCS, and modifiers.
• Identify correct diagnosis and procedure codes to support medical necessity and resolve edits.
• Validate charge-master driven CPT code assignments and route appropriately.
• Abstract data elements including disposition, dates, physicians, and occurrence codes.
• Determine when physician queries are needed and route missing documentation for clarification.
• Complete review and final coding when documentation is available.
• Maintain quality and productivity standards; mentor/train as requested.
• Maintain up-to-date knowledge of coding guidelines and practices.

Skills

Remote environment

Advanced computer skills

Education

Bachelor's/Associate in Health Information Management

RHIA/RHIT/CCS/CPC/CPC-H certification

Tools

3M 360

Epic

Job description

Contract: 2 months with strong possibility of extension

Facility coding experience

Cancer Center clinic coding experience

Transplant clinic coding experience

Agency must provide equipment

ESSENTIAL FUNCTIONS

• Responsible for coding retrospective outpatient accounts using ICD-10 CM, CPT, HCPCS, and Modifiers in compliance with the Official Coding Guidelines and conventions.
• 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.
• Validates charge-master driven CPT code assignments and routes appropriately.
• Accurately abstracts required data elements including, discharge disposition, procedure dates and physician(s), applicable occurrence codes, and other designated data.
• 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

• Maintain the Quality Standards set by UTSW/HIM Coding.
• Maintain the Productivity Standards set by UTSW/HIM Coding.
• Mentor/train on designated coding service lines as requested to ensure quality.
• Maintains an expert level of knowledge of coding related guidelines and practices.
• Other duties as assigned

MINIMUM QUALIFICATIONS

Education/Experience

• 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)