Professional Coding Specialist II - Outreach (Settings: Nursing Home; Skilled Nursing Facilitie[...]

WVU Medicine; Cheyenne (WY); On-site; USD 55,000 - 75,000; Full time

Job summary

SYSTEM West Virginia University Health System is seeking a Medical Coders to review medical records and assign ICD-10, CPT, and modifiers accurately for inpatient and outpatient encounters.

The role supports coding quality, charge capture, and clean billing while collaborating with physicians and other departments to improve documentation and coding accuracy.

Qualifications

• High School Diploma or Equivalent.
• Current HIM/Coding Certification through AHIMA or AAPC.
• Two (2) years of medical coding experience.

Responsibilities

• Review and assign ICD-10, CPT, or modifiers for diagnoses and procedures identified from medical records.
• Ensure daily coding, charging and abstraction for assigned areas is accurate and timely.
• Maintain and enhance coding knowledge through reviews, in-services and updates to manuals.
• Ensure data accuracy for a clean bill and communicate with physicians/offices as needed.
• Audit provider documentation and educate providers as needed to improve coding accuracy.
• Support Revenue Cycle Operations in claim development to resolve problem accounts.

Skills

Anatomy knowledge

Medical terminology

Attention to detail

Independent decision-making

Prioritization

Communication skills

Adaptability

Education

High School Diploma or Equivalent

Job description

Welcome! We’re excited you’re considering an opportunity with us! Below, you’ll find other important information about this position.

To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental, hospital and outside agency requirements. This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies. Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment, severity of illness and risk of mortality for each medical record. This position is an integral part of an overall compliance program effort as it pertains to physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives. Responsible for analyzing and resolving issues of missing charges and problem accounts by researching information regarding department reimbursement.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

• High School Diploma or Equivalent.
• Current HIM/Coding Certification through ONE of the following:
• American Health Information Management Association (AHIMA)
• American Academy of Professional Coders (AAPC)

EXPERIENCE:

• Two (2) years of medical coding experience.

PREFERRED QUALIFICATIONS:

• Two (2) years of physician office coding experience.

CORE DUTIES AND RESPONSIBILITIES:

• Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified.
• Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas.
• Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals.
• Assures the accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or any persons necessary to obtain information required to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process.
• Monitors on an on-going basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed.
• Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts.

PHYSICAL REQUIREMENTS:

• Must be able to sit for long periods of time.
• Must have visual and hearing acuity within the normal range.
• Must have manual dexterity needed to operate computer and office equipment.
• Must be Able to lift, push or pull 10-20 pounds.

WORKING ENVIRONMENT:

• Standard office environment.
• Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.
• May require travel.

SKILLS AND ABILITIES:

• Must be able to concentrate and maintain accuracy during constant interruptions.
• Must possess independent decision-making ability.
• Must possess the ability to prioritize job duties.
• Must be able to handle high stress situations.
• Must be able to adapt to changes in the workplace.
• Must be able to organize and complete assigned tasks.
• Must possess excellent written and verbal communication skills.
• Must meet quality and productivity standards.
• Must possess the knowledge of anatomy, physiology and medical terminology.

Additional Job Description:

This is working Outreach cases. Must have multi-specialty experience

Scheduled Weekly Hours:

40

Shift:

Day (United States of America)

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

539 SYSTEM HIM Provider Based Coding Analysis