Outpatient Surgery Coder — ICD/CPT Specialist

Carson Tahoe Health; Carson City (NV); On-site; USD 65,000 - 85,000; Full time

Job summary

Carson Tahoe Health is seeking an intermediate level clinical coding specialist to assign APCs, ICD codes, CPT/HCPCS codes, and modifiers for hospital outpatient and professional services.

You will work with the HIM team to ensure complete abstraction of data and maximize reimbursement, while adhering to coding guidelines and CMS requirements. The role includes analyzing denials, researching documentation, and maintaining accuracy and productivity.

Qualifications

• Active AHIMA membership
• Active AAPC membership
• Two years of previous coding experience or one year as a CTH clinical coder
• Associate’s degree in health information technology from an accredited program.

Responsibilities

• Assign compliant, complete, and accurate APC’s, ICD CM diagnosis codes, CPT/HCPCS procedure codes, E/M facility and professional level codes, and modifiers to outpatient and professional services.
• Work professional denials and claim edits. Identify trends in denials.
• Identify anatomy and physiology, clinical disease processes, pharmacology, and diagnostic terminology to assign accurate diagnosis codes.
• Knowledge and adherence to UHDDS definitions, ICD Official Guidelines for Coding and Reporting, and Coding Clinics for ICD for appropriate diagnosis coding.
• Validate and / or capture the charge for the designated procedures.
• Adhere to ICD instructional notations and coding conventions to locate, select, and sequence diagnosis codes appropriately.
• Adhere to AMA CPT Assistant and AHA Coding Clinic for HCPCS for appropriate CPT procedure coding.
• Adhere to CPT instructional guidelines and notations to locate, select, and correctly sequence procedure codes appropriately.
• Adhere to regulatory (CMS) and other third party payer requirements pertaining to clinical documentation, coding and billing.
• Abstract accurately from the medical record all defined data elements such as diagnoses, procedures, modifiers, attending physician, surgeons, discharge disposition, hospital service, etc.
• Retrieve any missing documentation needed to ensure compliant coding and optimal reimbursement.
• Clarify with the appropriate provider and HIM analysts all incomplete, ambiguous, and / or conflicting clinical documentation when further specificity is needed for accurate and complete code assignment.
• Investigate and resolve claim edits received such as medical necessity, Medicare Outpatient Code Edits (OCE), or Correct Coding Initiative (CCI) edits.
• Maintain consistent level of accuracy and productivity standards.
• Maintain continued education requirements of AHIMA or AAPC.
• Assist with special projects as needed and performs related duties as assigned.

Education

AHIMA RHIA or AHIMA RHIT or AHIMA CCS or CCS-P or AAPC CASCC or AAPC CGSC or AAPC COC or AAPC CPC or AAPC CIRCC or AAPC CANPC or AAPC CCVTC or AAPC CCC

Associate’s degree in health information technology

Job description

Carson Tahoe Health is seeking an intermediate level clinical coding specialist to assign APCs, ICD codes, CPT/HCPCS codes, and modifiers for hospital outpatient and professional services.

You will work with the HIM team to ensure complete abstraction of data and maximize reimbursement, while adhering to coding guidelines and CMS requirements. The role includes analyzing denials, researching documentation, and maintaining accuracy and productivity.