Coder II-III

Whidbey General Hospital • Coupeville, Washington, United States • 1w ago

Coder II-III

Experience preferred. Certified Coder with 5+ years experience coding professional and facility fees for surgical cases and office visits. Specialties include Obstetrics/Women's Health, Orthopedics, Podiatry, Cardiology, Urology & General Surgery.

JOB SUMMARY

The Coder is responsible for reviewing discharge abstracts and patient charts in order to assign the appropriate ICD-CM/CPT codes to diagnoses and procedures. Reviews charts for potential liability risk and documents specific information as necessary. Performs studies as requested by physicians or administration. Maintains State reporting documentation for certain procedures in compliance with regulations.

The Coder encounters the mission of providing quality healthcare to the patients of WhidbeyHealth to ensure medical records are charged and coded accurately and efficiently. This position may be responsible for applying the appropriate codes for ICD-10, CPT / HCPCS, evaluation and management, and/ or modifiers to encounters for claims processing, or assessing, charging, and reconciling encounters. The Coder follows all federal, state and payer specific regulations and policies pertaining to documentation and coding requirements to ensure all work is in compliance with quality and established guidelines.

Coding positions within this Job Description are meant to encourage job growth with applicable career ladders. Prior to moving to a higher-level coding position, a Coder must meet the standards under the applicable career ladder before transfer to the new level will be made. Career ladders are not automatic and must be approved by the applicable Supervisor or Manager prior to movement to a higher level.

PRINCIPLE FUNCTIONS includes the following, other duties may be assigned:

Responsibilities Coding Charge Specialist:

Ensure all appropriate services are ordered, captured, and documented for the assigned department. CPT/HCPCS codes are entered into Meditech BAR using chargemaster codes.
Use appropriate tools and/or books to support proper assignment of codes and charges.
Daily charge audit reconciliation functions will be performed to ensure accuracy.
Perform regular auditing and monitoring of charge capture.
Prioritize duties to ensure charge capture is completed timely and accurately per rules, regulations, and policies, as set forth.
Experience in reviewing Provider documentation and orders to ensure appropriate coding assignments.
Familiar with NCCI edits and LCD / NCD standards.
Charge and code according to specific related production standards for each area.
All cases will be charged within 4 days of service except in those cases where additional documentation or late charges apply.
For identified coding/billing errors, analyze, and investigate source of error to prevent future reoccurrence. Correct errors timely and communicate effectively with Patient Financial Services.
Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPC).
Adhere to official coding guidelines published by the American Medical Association, American Hospital Associate and coding clinic guidelines.
Maintain the highest degree of confidentiality of all information encountered including verbal, written and computerized.
All other work duties as assigned by Supervisor/Manager.

Responsibilities Medical Coder:

Assigns diagnostic and procedures codes and abstracts data to outpatient and/or inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory body guidelines.

Thoroughly review clinical documentation as appropriate to accurately assign appropriate ICD10CM, ICD10PCS, CPT and/or HCPCS codes for billing, internal and external reporting, research, and regulatory compliance. For inpatient hospital coding group codes into appropriate DRG and/or APC using Meditech and 3M groupers and review documentation for accurate POA indicator assignment.
Understand and accurately apply Modifiers.
Verify medical necessity for Medicare patients receiving services regulated by NCD's and LCD's.
Accurately abstract all pertinent information from patient record to include disposition, provider information, diagnostic and procedural information and other data for data retrieval and qualitative analysis.
Follow compliant query processes.
Adhere to productivity benchmarks with a goal of 95% coding accuracy of AHIMA/AAPC Standard. Productivity standards must be met for all services coded over six months. Demonstrate accountability for accurate and timely completion of daily work assignments by meeting or exceeding productivity expectations. Must maintain acceptable coding accuracy, quality and productivity standards.
Prioritize workload to assure accounts are coded timely. All records will be coded FOUR days after discharge except for records needing additional documentation or delay in receiving record from a department. Research accounts that have not been coded within the four-day timeframe and follow up as appropriate.
Stay abreast of all changes in coding conventions and coding updates.
For identified coding/billing errors, analyze, and investigate source of error to prevent future reoccurrence. Correct errors timely and communicate effectively with Patient Financial Services.
Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Association of Physician Coders (AAPC).
Adhere to official coding guidelines published by the American Hospital Association and the AMA for CPT guidelines.
Follow Whidbey Health Coding policies.
Maintain the highest degree of confidentiality of all information encountered including verbal, written and computerized.
Complete education as assigned by Supervisor/Manager
All other work duties as assigned by Supervisor/Manager.

Professional Service Coding:

Adhere to all requirements listed above under Responsibilities Medical Coder.
Complete on-site routine and complex encounter coding for clinic and hospital professional services, acts as clinic site expert.
Accurately post charges into billing system.
Perform provider training as requested.

JOB KNOWLEDGE & QUALIFICATIONS

Education

Coder II Required Education and Experience

Highest level of education completed, minimum high school diploma or equivalent required.
Completion of AHIMA / AAPC training course or comparable medical billing and coding certificate program required.
Certified Coder with 0-2 Years of coding experience.

Coder III Required Education and Experience

Highest level of education completed, minimum high school diploma or equivalent required. Completion of AHIMA / AAPC training course or comparable medical billing and coding certificate program required.
Certified Coder with 2 or more years of ICD10CM coding experience with WhidbeyHealth.

A Coder ll is eligible to move to Coder III after the completion of two (2) consecutive years as a Coder ll with Whidbey Health with demonstrated proficiency in ICD10CM coding and proven ability to code multiple services (LAB, DI, EMS, REHAB, CAM, LC, NS, RT, SC, WFO) and at least one additional service line (a service line is defined as IP, OBS, SDS, ED and/or MAC) or Professional Service Coding of E/M and CPT procedural coding for two or more areas (areas are defined as (Primary care, Walk in clinic, General Surgery, Orthopedics and/or Obstetrics/Gynecology). Be able to perform all essential functions and competencies of the position with no current performance improvement documentation on file. The Supervisor, Manager and/or employee can initiate the progressive change with Human Resources.

Certificates, Licenses, Registrations

CCA, CCS, CCS-P, CPC, COC, CIC, CRC or other valid AHIMA and/or AAPC coding certification.

Health & Well-Being You Can Count On

We offer a thoughtful, comprehensive benefits package designed to support you and your family at every stage of life:

Medical Coverage – HDHP w/HSA / PPO
Prescription Drug Coverage
Dental Options – PPO / Managed-Care Plan
Vision Benefits – VSP
Life & AD&D Insurance – Employer paid coverage
Long-Term Disability Coverage – Employer paid income Protection
Health Savings Account (HSA) – If enrolled in HDHP
Healthcare Flexible Spending Account (FSA) – Dependent & Healthcare
Employee & Provider Assistance Programs – Free, confidential support
Voluntary Life & AD&D Insurance – Additional employee paid buy up option
Voluntary Long-Term Disability Coverage – Additional employee paid buy up option

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