Position Summary: Reviews and validates outpatient clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical reporting, research, regulatory compliance and reimbursement.
Applies knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes.
Analyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD 10 CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to inclued Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required.
Adheres to all department coding procedures, policies, guidelines and quality standards.
Complete on a daily basis cases that have been assigned to them utilizing the appropriate work lists.
Coding responsibility includes but is not limited to the following:
Professional Primary Care Services
Undelivered/Labor & Delivery
Home Heath coder conducts chart reviews using current version of OASIS.
Assists manager with special projects/other tasks as assigned
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.
Review claim edits and revise coding/charging as appropriate for specific range of ICD-10-CM/CPT/HCPCS codes.
Review claims returned from various departments due to edits and process corrections for clean claim submission or post claim denial review for appeal.
Seeks clarification from physicians or other staff in cases where documentation is absent, ambiguous, or contradictory
Makes corrections based on collaboration with clinician or designee.
This position reports to Outpatient Coding Manager
Qualifications Education: High School Diploma or GED is required. Associate Degree is preferred.
Knowledge of anatomy and physiology, pathophysiology
Zero to one year of progressive on-the-job experience in an acute care hospital, physician office or Home Health.
Home health/hospice experience considered:Clinician with experience
Prefer one to two years of progressive on-the-job experience in a hospital, OP Hospice, physician or Home Health setting
Licensure, Certification, Registration: CPC, CPCH, CCS, HCS-D and/or HCS-H certification required within 12 months from date of hire and maintained thereafter.
ICD 10-CM diagnostic and CPT/HCPCS procedure codes
Working knowledge of clinical information
Microsoft Office Products; Word, Excel
Encoder and/or CAC
Read, write and speak English proficiently.
Solid analytical capabilities.
Good organizational skills.
Proficiently read and interpret physician writing.
Handle multiple priorities.
Listen and acknowledge ideas and expressions of others attentively.
Converses clearly using appropriate verbal and body language.
Collaborate with others to achieve a common goal through mutual cooperation.
Influence others for positive and productive outcomes
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment. RegularStandard Hours:40Schedule:Full-time
Associated topics: authorization, billing, cbo, clerk, data, desk, hospital transcriptionist, medical coder, receivable, review
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.