Outpatient Coder - SS Revenue Cycle - Toledo Market

Bon Secours Health System; Toledo (OH); Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated Outpatient Surgery Coder to join their compassionate team. In this remote role, you will utilize your coding expertise to review medical records and ensure accurate coding of outpatient visits, including urgent care and same-day surgeries. You will be responsible for maintaining compliance with federal regulations while working collaboratively with a team to support timely billing processes. This is a fantastic opportunity to contribute to a legacy of providing exceptional care and to grow your career in a supportive environment that values your skills and commitment to excellence.

Benefits

Comprehensive medical, dental, and vision plans

Prescription drug coverage

Flexible spending accounts

Life insurance w/AD&D

Employer contributions to retirement savings plan

Paid time off

Educational Assistance

Qualifications

• Must have outpatient surgery coding experience with ICD-10 and CPT IV coding.
• Completion of Coding Curriculum with one year of previous coding experience.

Responsibilities

• Review medical records and assign appropriate ICD and CPT codes accurately.
• Monitor accounts for timely and compliant processing of outpatient claims.

Skills

Outpatient Surgery Coding Experience

ICD-10-CM

ICD-10-PCS

CPT IV coding

Medical Terminology

Anatomy and Physiology

Excellent communication skills

Keyboarding skills

Education

Vocational/Technical Degree in HIM/Coding Certification

2 year/Associate's Degree in HIM/Coding Certification

Tools

3M software tools

LYNX

Computerized Assisted Coding (CAC)

Job description

With a legacy that spans over 150 years, Bon Secours is a network that is dedicated to providing excellent care through exceptional people. At every level, everyone on our teams have embraced the call to provide compassionate care. Here, you can work with others who share common values, and use your skills to help extend care to all of our communities.

This position is a work-from-home role.

**Must have Outpatient Surgery Coding Experience**

Advanced outpatient coding position that reviews medical record documentation and accurately assigns ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association (AHIMA) Coding Ethics, as well as the American Hospital Association (AHA) Coding Clinics, CMS directives and Bulletins, and Fiscal Intermediary communications. Utilizes Coding Applications in accordance with established workflow. Follows Mercy Policies and Procedures and maintains required quality and productivity standards.

ESSENTIAL FUNCTIONS

• Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types (Ancillary, ED Charge/Code, Same Day Surgery, and Observation). The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using third-party software systems such as LYNX.

• Correctly abstract required data per facility specifications.

• Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines.

• Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensuring timely, compliant processing of outpatient claims in the billing system.

• Responsible to maintain established productivity requirements and key performance indicators established for 3M 360 CAC for CRS & Direct Code, as well as ensure accuracy to maintain established quality standards.

• Remain abreast of current requirements of the Centers for Medicare & Medicaid Services (CMS), to include National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through.

• Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding (CAC), Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, and reports any potential unethical and/or fraudulent activity per compliance policy.

• Follows all established Mercy Health policies and procedures to include abiding by paid time off (PTO) requirements.

• Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth.

• Training/Mentoring - SMART Responsibilities where applicable.

Required Minimum Education:

Vocational/Technical Degree, Specialty/Major: HIM / Coding Certification

Preferred Education: 2 year/Associate's Degree, Specialty/Major: HIM / Coding Certification

LICENSURE/CERTIFICATIONS (must be non-expired/active unless otherwise stated):

Required: If RHIA or RHIT or CCA upon hire without COC or CCS, will be required to acquire COC or CCS and CRCR within 1 year of hire.

Preferred: RHIA or RHIT or CCS or COC or CCA or CPC.

MINIMUM QUALIFICATIONS

Minimum Years and Type of Experience: Completion of Coding Curriculum with one year of previous coding experience.

Other Knowledge, Skills and Abilities Required: Satisfactory completion of Medical Terminology and Anatomy and Physiology. Completion of ICD-10 training. Previous use of Coding Software Tools. Knowledge of medical record content to include electronic medical records (EMRs). Ability to function independently, with minimal supervision, as well as part of a team. Ability to function under continual deadlines. Ability to maintain accuracy during frequent interruptions. Proficiency in keyboarding skills and working knowledge of computers. Excellent communication skills.

Other Knowledge, Skills and Abilities Preferred: Previous coding experience in an acute care setting and previous use of coding software tools. Previous use of CAC.

Many of our opportunities reward your hard work with:

• Comprehensive, affordable medical, dental and vision plans
• Prescription drug coverage
• Flexible spending accounts
• Life insurance w/AD&D
• Employer contributions to retirement savings plan when eligible
• Paid time off
• Educational Assistance
• And much more

*Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email [e-mail]. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [e-mail].