Centra

Job Description

The Hospital Outpatient Coder I is an entry level position responsible for coding Clinic Provider Based Billing (PBB) facility and Outpatient Diagnostic encounters for the purpose of reimbursement, statistical analysis, and other clinical purposes in compliance with federal, state, and regulatory agencies’ guidelines using the most current International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and Current Procedure Terminology (CPT) classification systems. Performs clinical documentation review, coding, charge entry, and charge review that includes appending modifiers to resolve claim edits. The Outpatient Hospital Facility Coder I will be responsible for coding the following services: Screening and Diagnostic Mammogram, Education, Diagnostic Imaging, Women and Children’s Clinics, PreOperative Services, Sleep Disorders, Stroobants Cardiovascular Center and Pain Clinic Provider Based Billing.

Responsibilities

Essential Duties and Responsibilities:

• Reviews clinical documentation and assigns appropriate Provider Based Billing (PBB) facility Evaluation and Management, ICD-10-CM for the purpose of reimbursement using the 3M Coding and Reimbursement System.
• Reviews clinical documentation and assigns appropriate Outpatient Diagnostic ICD-10-CM codes using abstract software.
• Resolves the National Correct Coding Initiative (NCCI) and medical necessity edits in the 3M Coding and Reimbursement software to ensure clean claims submission.
• Ensure assigned queues are worked timely and efficiently.
• Maintains coding education requirements for required coding certifications.
• Works closely with outpatient coding team, managers, Communicates in a positive and professional manner.
• Maintains productivity and accuracy standards set by Centra.

Other Functions:

• Observes confidentiality and safeguards all patient related information.
• Remote home office skills including PC use and maintenance, knowledge of Microsoft Office products including Excel and Outlook.
• Performs other duties as assigned.

Travel Required

Travel is expected to be between 0% to 10% of the time.

Travel may be needed occasionally for training and or other educational opportunities.

Qualifications

Required Qualifications:

• Certified Professional Coder-Apprentice (CPC-A) eligible.
• A career studies certificate in Medical Coding and eligible to sit for either AAPC Certified Professional Coder credential or AHIMA Certified Coding Specialist or Certified Coding Specialists-Physician credential exam.
• Obtain coding credential through APPC or AHIMA within 1 year of hire date and maintain credential.

Preferred Qualifications:

• Certified Professional Coding Certification - Apprentice (CPC-A); or
• Certified Coding Associate (CCA)