Job Description

POSITION: CERTIFIED OUTPATIENT MEDICAL CODER (possible REMOTE- Work From Home)
HOME OFFICE LOCATION: Irving, TX (zip 75063)

POSITION SUMMARY:

Responsible for translating healthcare providers’ diagnostic and procedural phrases into coded form. Reviews and analyzes health records daily to ensure correct coding.

POSITION RESPONSIBILITIES:

• Analyzes provider documentation to assure the appropriate ICD-10 Diagnosis codes, CPT/HCPCs Codes, and ICD-10 PCS Codes are assigned accurately based on medical documentation.
• Evaluates the calculated DRG for accuracy.
• Assists billing staff establish the medical necessity of charges, claims, and clearinghouse edits.
• Provides feedback to the clinical staff on coding issues and reviewing denials.
• Provides training to each provider regarding errors identified and corrected.
• Obtains necessary clarification of information on the notes and charts by physician query.
• Provides weekly trending reports by provider to COO or designated administrator; regarding coding errors, coding changes, missing information from charts, etc.
• Ensures that all medical records have been signed by the appropriate parties
• Evaluates medical records for documentation consistency and adequacy.
• Reviews appropriate medical codes to all diagnoses or services.
• Enters and organizes the codes into management software.
• Reviews records for compliance with established third party reimbursement agencies and special screening criteria.
• Assists in coding denials and providing other billing resolutions as needed.
• Completes coding projects as needed.
• Attends various meetings and professional development programs as required.
• Billing and assisting with claims submission as needed.
• Other duties as assigned.

OTHER RESPONSIBILITIES:

• Completes required orientation as directed by facility

• Follows facility and OSHA safety rules and procedures while on assignment

• Follows facility Unusual Occurrence Protocol

• Respects cultural and religious practices of patients

• Upholds HIPAA regulations

• Punctual and dependent for assigned/confirmed shifts

POSITION REEQUIREMENTS:

• Knowledge of the ICD-10 CM/PCS, and CPT-/HCPCS universal coding systems
• Knowledge of DRG systems
• Knowledge of coding and clinic operating policies
• Must be efficient, organized, and have the ability to set priorities and meet deadlines.
• Knowledge of insurance carrier coding requirements to ensure proper coding based on License and specialty
• Strong computer skills in MS Office/Windows (Word and Excel required).
• Knowledge of Medical terminology
• Strong communication and organizational skills (written and verbal), ability to work across functions with customers (both internal & external)
• Knowledge of third party billing procedures across a variety of payer systems
• Ability to prioritize workload proactively and expeditiously.
• Detail-oriented and highly organized.
• Knowledge of billing and financial concepts
• Works well in an environment with firm deadlines; results oriented
• Perform multiple tasks effectively
• Able to work both independently and as part of a team
• Strong analytical skills required
• Capable of making timely, independent decisions
• Ability to identify and maintain confidential material.
• High School Diploma or GED required.
• RHIT, RHIA, CCS, or CIC certification Required.
• Strong Facility coding knowledge and experience.

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