Outpatient Complex Coder

Banner Health; Phoenix (AZ); Hybrid; USD 37,000 - 56,000; Full time

Job summary

Banner Health is seeking a motivated Outpatient, Acute Care, HIMS Complex Coder to join our nationwide remote SDS complex facility-coding team. The role focuses on outpatient complex surgical and observation coding across multiple service lines with ICD-10-CM/PCS and CPT4 coding and APC assignments.

Candidates should have 2+ years of outpatient facility-based coding experience, be certified through AHIMA or AAPC, and be able to navigate NCCI edits and regulatory guidelines.

Qualifications

• 2 years of recent outpatient facility-based coding experience for same day surgery and observation.
• Proficient in ICD-10-CM/PCS and CPT coding; eligible for CCS, COC, CPC, RHIT or RHIA certification.
• Ability to work remotely with effective communication and independent work habits.
• Coding assessment will be given within 48 hours after interview.

Responsibilities

• Code outpatient complex surgical and observation cases using ICD-CM/PCS and CPT4 for accurate APC assignment.
• Review documentation, clarify missing info with providers, and ensure regulatory compliance.
• Mentor less experienced staff and address complex coding matters independently.

Skills

Outpatient coding

ICD-10-CM/PCS

CPT4

Education

AHIMA/AAPC certification

Job description

Department Name: Coding-Acute Care Hospital Work Shift: Day Job Category: Revenue Cycle Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Looking for a motivated, experienced Outpatient, Acute Care, HIMS Complex Coder to join our talented Outpatient SDS Complex Facility-coding team.

Candidate should have complex coding experience in acute care, all service lines including, but not limited to: General, Orthopedic, Urology/Gynecology, Cardiac, Spinal, etc.

Requirements

2 years recent experience in Outpatient Facility-based coding of Same Day Surgery & Observation (clearly reflected in your attached resume); Experienced in ICD-10-PCS & ICD-10-CM coding; as well as CPT Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please note, this is a COMPLEX role, requiring more than CPC-A level experience. A Coding Assessment will be given after a successful interview to be completed within 48 hours. Banner Health provides your equipment when hired. You will be fully supported in during initial training by both the Banner Coding Education team and your hiring manager, with continued support throughout your career here!

The hours are flexible with the ability to work your 8-hour shift between 5am-7pm (Monday-Friday). This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY.

Banner Health the best place to work and receive care. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you’ll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position provides coding and abstracting for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities. Reviews health record documentation and assigns diagnoses and/or surgical procedure codes on all outpatient complex records using ICD CM/PCS and CPT4 coding classification systems. Completes APC assignment on outpatient complex records as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and nationally recognized coding guidelines.

CORE FUNCTIONS

1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information, including modifiers, in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM/PCS and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required.
2. Abstracts clinical diagnoses, procedure codes and other pertinent information obtained from the patient encounter. Place account in the appropriate status for required missing documentation to complete assignment of disease and procedure codes, and any pertinent abstract elements.
3. Provides quality coding by ensuring compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as Banner specific policy and procedures and applicable professional standards for a full range of outpatient complex surgical and observation acute care services at all Banner hospitals. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities.
4. May provide mentoring for less experienced staff members. May act as a subject matter expert for complex coding.
5. Works under general supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address complex coding matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to coding analyst, coding educator, or coding manager/supervisor. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

SUPERVISORY RESPONSIBILITIES

DIRECTLY REPORTING None

MATRIX OR INDIRECT REPORTING None

TYPE OF SUPERVISORY RESPONSIBILITIES N/A Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner.

PHYSICAL DEMANDS/ENVIRONMENT FACTORS

OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager) Requires extensive sitting with periodic standing and walking. May be required to lift up to 20 pounds. Requires significant use of personal computer, phone and general office equipment. Needs adequate visual acuity, ability to grasp and handle objects. Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone. May require off-site travel.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge and specialized formal training in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a health care field. Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certificaion in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Requires two or more years of outpatient complex experience in an acute care inpatient facility or healthcare system. Must demonstrate a level of knowledge and understanding of ICD CM/PCS, CPT4 coding principles and coding competencies as demonstrated by certification through the American Health Information Management Association or by the American Academy of Professional Coders. Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.

PREFERRED QUALIFICATIONS

Associates degree in a job-related field or experience equivalent to same. Previous experience in large, multi-system healthcare organization. Additional related education and/or experience preferred.

DATE APPROVED

06/09/2024

Estimated Pay Range

$27.35 - $41.03 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

Anticipated Closing Window

(actual close date may be sooner): 2027-03-05

EEO Statement

EEO/Disabled/Veterans Our organization supports a drug-free work environment.

Privacy Policy

Privacy Policy. Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee. We are proud to offer a comprehensive benefit package for all benefit-eligible positions. Please visit our Benefits Guide for more information.

Contact

Need help? Contact the Banner Health Talent Acquisition team at [e-mail].