To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Reporting to the Supervisor of Outpatient Coding, The OP Senior Coder is a vital multifaceted role within the
Outpatient Coding Department. This position provides support to the Outpatient Coding Department as a OP coding
subject matter expert, educator, QA reviewer, and also focuses daily efforts on A/R management and oversight. Additionally, this person works with partner departments to problem solve issues and streamline processes. The OP Senior Coder is also required to mentor other team members and also prepare them for the role of OP Senior Coder . The OP Senior Coder possesses a strong level of OP clinical coding expertise, and has the ability to handle multiple priorities. This position requires strong ICD-10, CPT and PCS coding skills, in addition to being able to perform QA
reviews, educate and mentor team members, and identify, monitor, trend and resolve issues via dashboards to
manage the AR.
EEO/AA/Disability/Veteran
Manages in collaboration with the OP Coding Leadership team the day -to-day activities related to Outpatient
Coding AR to ensure accuracy, completeness, and timeliness of coding completion.
This includes, but is not limited to: ongoing communication and collaboration with internal and partner
departments to resolve outstanding issues and streamline workflows, monitoring internal waiting accounts for
appropriate coding status application and follow-up and working with team members to resolve issues, monitoring internal volumes and coding capacity to meet goals and making changes and /or
recommendations as appropriate, coding cases and resolving coding claims edits to adhere to billing
deadline, and drafting compliant OP clinical queries.
1.
2. Serves as a subject matter expert in OP coding and existing workflows to staff and partner departments.
Responsible to conduct regular QA reviews to identify coding errors and trends , communicate findings, and
monitor cases for improvement. Works closely with OP training and education team on findings and /or trends. May work with audit educator to educate and train internal staff .
3. Capable of coding all OP service lines and maintains a minimum of 95% overall coding quality score in
diagnostic, procedural, and modifier code selection. May need to production code based on department
needs, and codes cases on a regular basis to reduce outstanding AR.
4. Participates and seeks out career development activities by reading journals, coding articles, researching
procedures and/or disease processes to ensure appropriate code selection, regularly attends coding
education sessions, and leads learning circles. Shares information with team members, and works in
conjunction with audit educators to mentor and provide coding support.
5. Prioritizes coding workload appropriately by focusing efforts on cases and service lines with the potential to
impact department goals. Mentors and provides guidance to fellow team members on prioritizing their coding
workload, when needed, to improve AR.
6.
7. May serve in a lead capacity to provide support to the staff in absence of their supervisor.
8. Works closely with the OP Vendor Relations Coordinator and this position provides coverage support, as
needed. This includes, but is not limited to: being familiar with processes in place for the vendors, points of
contact, tracking, etc.
9. Performs all other duties or special projects requested by manager.
10. Exhibits enthusiasm for the profession, rembraces educational opportunities and department support offered
and remains engaged in the goals and vision of the department. Role models the professional standards of
behavior and encourages staff to do the same.
EDUCATION:
Bachelor degree preferred in a health related field. Required coursework, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process. RHIT or RHIA preferred.
EXPERIENCE:
Five (5) or more years of progressive coding experience in Outpatient Coding. Must be fully proficient in all OP service lines, which includes ancillary/radiology, ED/Observation, SDS, Oncology, infusion and injection coding, IR and Cardiology, and all current OP workflows. Prior experience in Epic and 3M required. Must have working knowledge in resolving coding claim edits, and general understanding of the revenue cycle. Audit educator and /or coding support experience strongly preferred.
SPECIAL SKILLS: Must have extensive knowledge of all service lines within OP coding, includes all official coding guidelines and
internal workflows. Must be able to resolve coding claim edits and have a general understanding of the revenue
cycle. Advanced knowledge of Excel is required, for the ability to track, trend, and report. Must be able to create
dashboards, presentations, educational coding tools and procedures with the use technology and /or reporting to
ensure coding compliance, proficiency and adherence to DNFB/DNFC targets.
ACCOUNTABILITY:
Must meet the defined department accuracy standards in all OP coding areas. Ability to code and provide general
oversight into the timeliness of coding. This requires active working knowledge of all coding processes and
workflows, the ability to identify trends, resolve all types of coding issues, and must be able to communicate issues
upon identification and track improved performance. Must work collaboratively with the OP Leadership team ,
including the OP Vendor Relations Coordinator, to ensure OP coding AR is at optimal levels. Practices, adheres,
and enforces the AHIMA code of Conduct philosophy. Must be able to work independently with minimal guidance
and as part of a team. Promotes, fosters and role models a positive working environment using YNHH Standards of
Professional Behavior.
COMPLEXITY:
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Position requires dealing with a variety of situations. Must have the ability to work autonomously on complex coding and
issue resolution for all service lines, streamline work processes, prioritize efforts to support the OP Leadership team and
also a critical play in providing daily support to manage the AR. Must be able to conduct QA reviews and provide
guidance and support to team members. Must have strong attention to detail, the ability to train and educate in a clear
and concise manner, superior organizational skills and strong communication skills (verbally and written.)
LICENSURE/CERTIFICATION:
CPC and/or CCS credential required. RHIT or RHIA preferred. CCC and/or CIRCC credential required. Additional relevant coding certifications preferred.
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