PB Coder 2 - Outpatient

Beth Israel Lahey Health; Boston (MA); On-site; USD 31,000 - 63,000; Full time

Job summary

Beth Israel Lahey Health is seeking an OP Coder to join the outpatient coding team. Under the supervision of the OP Coding Manager, you will review records and assign ICD-10-CM, CPT, HCPCS and modifiers to ensure accurate APCs and compliant billing.

You will collaborate with Coding leadership and validators to maintain coding uniformity, accuracy, and timeliness, while meeting quality and productivity targets in a fast-paced hospital setting.

Qualifications

• Minimum qualifications include a High School Diploma or equivalent plus a recognized Coding Certificate.
• CPC or CCS-P certification is required.
• 2+ years of ICD-10-CM, CPT/HCPCS outpatient coding experience preferred.

Responsibilities

• Review outpatient records and assign ICD-10-CM, CPT, HCPCS and modifiers for APC determination.
• Meet productivity and accuracy standards set by management.
• Perform prospective audits and provide feedback to providers.

Skills

Medical terminology

Microsoft Office (Excel/Word/PowerBook

ICD-10-CM & CPT knowledge

EMR systems

Written communication

Health information laws

Policy adherence

Education

High School Diploma or equivalent

Coding Certificate

Tools

Epic

3M-360 Computer Assisted Coding

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing.

Job Description

Essential Duties & Responsibilities

Professional Coding Coding Responsibilities

• Provides review and/or coding of any professional services including but not limited to surgeries and diagnostic services for appropriate use of CPT, ICD-10 - CM, HCPCS, and Modifier usage/linkage as well as provide ICD-10- CM coding where needed for missing diagnoses.
• Productivity and accuracy standards must be met according to guidelines set by the manager.
• Prospective audit of charges entered by providers as well as provide feedback to providers
• Periodic review of codes, at least annually or as introduced or required for new, revised, or deleted code updates.
• Answers and responds accurately and timely to questions from providers and other departments
• Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding when necessary
• Reports regularly on findings of reviews/rejections as required by the manager.

Physician/Provider Education

• Confers regularly with physicians/other qualified health care providers, clinical or ancillary managers, coders, or other staff through departmental staff meetings, one-on-one meetings, and/or daily interactive communication to respond to and educate providers on specific departmental and clinic-wide coding issues and updates.
• Participates in new physician/care provider orientation as well as provides follow-up reviews and education for the new physician/care provider if applicable for the area of responsibility.
• Provides feedback, recommendations, and participates as the coding representative for the Professional Coding Department on the Revenue Cycle Teams as requested by the manager.
• Develops and conducts a schedule of physician/care provider documentation reviews in areas where applicable and/or as defined by the manager.
• Provides feedback to the physician/other qualified health care provider, Department Chair, and/or Administration as required.
• Documentation review is ongoing and feedback will be provided to the physician/ other qualified health care provider, Department Chair, and/or Administration as required.

Education

Minimum Qualifications:

• High School Diploma or equivalent, plus additional specialized training associated with the attainment of a recognized Coding Certificate.

Licensure, Certification & Registration

• CPC (Certified Professional Coder through the American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through the American Health Information Management Association)

Experience

• Minimum 2 years of ICD-10-CM, CPT/HCPC Outpatient coding assignment, required
• Microsoft Office applications
• Interventional Radiology, Cardiac Cath, Injection and Infusion, Observation, and Ambulatory Surgery coding experience, preferred
• Computer skills

Required Skills, Knowledge & Abilities

• Medical terminology
• Proficient in Microsoft Office Excel, Word, and PowerPoint applications
• Knowledge and understanding of current ICD-10-CM and CPT Official Guidelines for Coding and Reporting
• Knowledge of medical records content and management
• Working knowledge of the EMR either through experience or education, including experience working with structured data and database management
• Strong written communication skills
• Knowledge of laws and regulations about health information and patient confidentiality
• Adheres to Department, Hospital, and Human Resource Policies

Preferred Qualifications & Skills

• Epic experience
• 3M-360 Computer Assisted Coding

Dept./Unit-Specific Skills

• OP Coder II level ICD-10-CM, CPT Outpatient code assignment skills based on BILH OP Coder Exam

Key Business Relationships: (Title and Purpose)

1. 1 Coding Director Day to day direction, scheduling and support
2. 2 Medical Staff Provide support, education and training
3. 3 Coding colleagues Process improvement, knowledge sharing, quality of work, productivity and training and education
4. 4 External facilities Work with hospitals, provider practices and vendors on requests related to Coding and Validation

Pay Range

$22.43 - $45.41

The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled