OUTPATIENT CODER (OCCASIONAL ONSITE REQUIRED)

Covenant HealthCare; Saginaw (MI); On-site; USD 50,000 - 70,000; Full time

Job summary

Covenant HealthCare is seeking a Health Information Management Coding Specialist to ensure timely and accurate clinical data for optimal reimbursement. Responsibilities include maintaining coding quality, assisting in departmental goals, and working collaboratively with medical staff. Candidates must possess relevant credentials such as RHIA, RHIT, or CCS, with a preference for those with outpatient coding experience. This role demands effective communication skills, problem-solving capabilities, and a commitment to ongoing professional development.

Qualifications

• RHIA, RHIT, or CCS credential required.
• Acute care outpatient coding experience preferred.
• Knowledge of outpatient coding preferred.

Responsibilities

• Ensure optimal reimbursement through accurate coding.
• Contribute to patient satisfaction goals.
• Maintain coding quality by following policies and guidelines.

Skills

Basic computer skills

Verbal communication skills

Problem resolution skills

Organizational skills

Interpersonal skills

Education

RHIA, RHIT, or CCS credential

Bachelor's or Associate Degree

Tools

EMR

Vital Ware

Excel

Job description

Overview

The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, and recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social.

Demonstrates excellent customer service performance in that his/her attitude and actions are consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation.

Responsibilities

• Contributes to organization success targets for patient satisfaction.
• Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members.
• Adhere to coding rules for outpatient coding, APC assignment, outpatient coding CCI edits and other to ensure quality coding based upon documentation with the patient record.
• May also code skilled care or rehab services with CMG assignment and IRFPAI completion.
• Follows policies, procedures, and guidelines to assure consistent coding quality. Utilizes analytical skills when reviewing charts, interpreting documentation, and applying codes, sufficing edits, reviewing pertinent charges, etc.
• Assures coding is completed timely and all work queues are maintained at a reasonable completion rate/turnaround timeframe. Willing to help others, accept help from others, and work extra when backlogs occur.
• Participates in HIM department meetings and area-specific meetings (OPC, charge master, clinical areas, resident/physician meetings, etc.) as required.
• Assist in achieving departmental, AR and area-specific goals.
• May work with external vendors/customers on issues, audits, or projects.
• Identifies solutions to problems and assists in resolving issues.
• Participates in identifying lean opportunities to enhance coding efficiency and lower AR.
• Shares knowledge during training of new staff and serves as a resource to others.
• Engages in independent learning for continued personal and professional growth; stays current on coding updates such as Coding Clinics and code changes.
• Utilizes references to support technical decisions and clinical understanding of disease processes or procedures/tests performed.
• Maintains professional credentials.
• Assist CBO/Finance/Data/CMG/Patient Safety and Quality/Other as requested for follow-up on items related to coding, billing, reimbursement. Ensures compliance with Federal (HIPAA) and State regulations.
• Demonstrates awareness of legal/confidentiality issues and adheres to HIPAA Privacy and Security and department policies and procedures.
• Participates in the development and attainment of department and workgroup goals.
• Performs other duties as assigned, which may include reviewing and analyzing coding denials, denial appeals, denial entries, writing appeal letters to outside agencies, coding quality reviews, training of new staff, mentoring students, or testing for new software upgrades.
• Helps develop or maintain guidelines, procedures, or policies.

Qualifications

Education/Experience Requirements

• RHIA, RHIT, or CCS credential required.
• Eligible Bachelor's or Associate Degree graduates will be considered with the expectation they pass the national exam.
• Acute care outpatient coding experience preferred (diagnosis and procedural coding utilizing ICD-10-CM and CPT-4 coding books and references including NCCI edits or modifiers).
• Clinical documentation knowledge of outpatient coding preferred.

Knowledge/Skills/Abilities

• Basic computer skills.
• Ability to work under stress, with frequent interruptions and deadlines.
• Knowledge of standard office equipment and computer use including EMR, email/Outlook, internet, encoder, and other software as needed (Vital Ware, Lawson, Excel).
• Demonstrates effective verbal and written communication skills.
• Uses organization/priority setting skills to complete work timely and accurately.
• Problem identification and resolution skills to support sound decision making.
• Interpersonal skills to work with many people and personalities.
• Ability to use sound judgement based on the latest guidelines, federal and state statutes, regulations, and hospital/department policies.
• Ongoing professional growth in many areas.
• Ability to sit and look at a computer screen for long periods and to be flexible as priorities change.

Working Conditions / Physical Requirements

Ability to maintain regular, punctual attendance consistent with ADA, FMLA and other federal, state and local standards.

• Constant sitting; use of hands to finger, handle and feel.
• Constant hearing and near vision; frequent depth perception, midrange and far vision; frequent color and field of vision.
• Frequent lifting 0-10 lbs; occasional lifting 11-50 lbs.
• Occasional standing, walking, carrying, pushing, pulling, climbing, balancing, stooping, kneeling, crouching, squatting and crawling.
• Occasional twisting, reaching and talking.