Coder II, PBO Coding, Full Time, First Shift

Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set.

Coding quality:

• Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG’s.
• Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation.
• Maintains a coding accuracy rating of at least 95% on records assigned.
• Queries physicians when necessary to ensure documentation supports the codes assigned.

Coding productivity:

• Performs coding on medical records in an efficient manner meeting productivity standards and assisting the department in meeting and maintaining its goals.
• Completes productivity data correctly and timely.
• Billing edits, coding corrections, DRG changes:
• Reviews, researches, and resolves claim edits for billing purposes.
• Reviews records following feedback from payers, auditors and managers and makes corrections to coding, disposition and/or DRG assignment when indicated.

Accountability:

• Reviews educational materials thoroughly and takes responsibility for applying this information when coding.
• Seeks to clarify information and educational material when necessary.
• Listens actively.
• Maintains information and resources in an organized manner so that information can be referenced easily.
• Reviews emails timely and thoroughly and responds when indicated.
• Manages the remote work setting effectively and comes on site when system, connectivity or other issues arise that would impact work performance.

Minimum Requirements:

• High School Diploma or GED.
• Formal education in ICD-9-CM/CPT coding, medical terminology, anatomy, pathophysiology, and disease processes.
• At least 1 year of acute care coding experience or equivalent relevant experience.
• Certification in one of the following: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS).

Preferred Qualifications:

• Associate's degree in a healthcare-related field.
• Bachelor's degree in a healthcare-related field.