Coder II

Job Summary:

The Coder II assigns and sequences ICD-10, CPT and HCPCS codes through review of outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. Codes complex accounts which requires advanced expertise in coding subject matters.

Duties/Responsibilities:

  • Assigns and sequences ICD-10, CPT and HCPCs diagnostic and procedural codes for outpatient accounts within NOAH. Reviews physician documentation and coding for appropriateness and accuracy and makes corrections following Medicare and AMA coding guidelines. May include abstract coding.  Utilizes electronic medical record and computer-assisted coding (CAC) software.  Addresses NCCI and LCD, and other applicable coding edits.
  • Complies with coding practices to meet FQHC compliance guidelines and to ensure appropriate and effective reimbursement. Reviews and analyzes medical records for accurate ICD and CPT code selection.
  • Abstracts information from clinical notes and assigns correct ICD-10, CPT and HCPCs codes and modifiers.
  • Maintains query communication with providers to ensure timely notification of identified documentation issues that may impact revenue or compliance.
  • Communicates and assists in education with an audience that may include physicians and clinical staff.
  • Assists Revenue Cycle team with interpretation and selection of appropriate ICD, CPT, and HCPCs codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of understanding of claim edits, rejections and denials.
  • Performs outpatient charge validation/ reconciliation to ensure all charges are posted accurately and timely.
  • Resolves routine coding issues/problems and appropriately seeks assistance from Revenue Cycle Supervisor.
  • Keeps supervisor informed of issues/problems and other such activities. Attends, participates, and/or assists in meetings, trainings, community outreach activities, continuing education opportunities, and other activities as required.
  • Performs other related duties as assigned.

Required Skills/Knowledge/Abilities: 

  • Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10, CPT, and HCPCs codes.
  • Working knowledge of charging and billing processes.
  • Working knowledge of Medicare, NCCI, LCD, NCD, and other claim edit guidelines and protocol.
  • Working knowledge of FQHC Billing regulations and compliance auditing.
  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Ability to self-motivate to complete required tasks.
  • Ability to function well in a high-paced and at times stressful environment.
  • Able to type a minimum of 50 words per minute.
  • Extremely proficient with Microsoft Office Suite or similar software with the ability to learn new or updated software.

Education and Experience:

  • High school diploma or GED required.
  • Associates degree in health related field preferred.
  • 2+ years of coding outpatient accounts required.
  • 4+ years of experience in coding complex outpatient accounts preferred.
  • CPC (Certified Professional Coder), COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist), RHIT (Registered Health Information Technician), or RHIA (Registered Health Information Administrator) or other qualified certification through AAPC or AHIMA required.

Physical Requirements: 

  • Prolonged periods sitting at a desk and working on a computer.
  • Ability to stand, walk, reach, stoop, bend, kneel, and squat.
  • Close vision (clear vision at 20 inches or less).
  • Ability to hear adequately to decipher spoken word, sounds, alarms, etc.
  • Able to use hands and fingers for fine manipulation to touch, pick, pinch, and grasp and perform repetitive motions.
  • Must be able to lift, carry, push, or pull up to 15 pounds at times.
  • Must be able to navigate various departments of the organization’s physical premises.

Other Requirements:

  • New Hires are required to pass pre-employment background check and drug testing (effective 11/1/2022).

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