Coder Abstractor-Outpatient

The Coder Abstractor-Outpatient, Level I is responsible for accurate data abstraction and code assignment following ICD-10-CM Official Coding Guidelines, International Classification of Diseases (ICD-10-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS). Performs data entry of required abstracted patient information into the electronic medical record system. Resolves NCCI, MUE, and Medical Necessity related edits. Record types include Outpatient Specialties, Pain Clinic, Wound Care, Cardiac Rehab, Sleep Study, Laboratory, and Radiology.

• Self-starter with a strong sense of ownership and the ability to work independently on assigned tasks as warranted and appropriate.
• Proficiency in Microsoft office applications.
• Knowledge of anatomy, physiology, and pathology of disease processes and medical terminology.
• Knowledge of ICD-10-CM and HCPCS coding systems, ICD-10-CM Official Guidelines for Coding and Reporting, AMA’s CPT Assistant and AHA’s Coding Clinic.
• Ability to review licensed provider’s documentation and apply diagnosis codes following the alphabetic and tabular index and ICD-10-CM Official Guidelines for Coding and Reporting.
• Stays current with reading and applying ICD-10-CM Official Guidelines for Coding and Reporting, AHA’s Coding Clinic and AMA’s CPT Assistant advice.
• Knowledge of NCCI, MUE, and Medical Necessity Edits. Ability to resolve NCCI, MUE, and Medical Necessity Edits.
• Organized, flexible, highly motivated, current with changing regulations and guidelines, insurance billing requirements, annual coding updates and internal data needs; general knowledge of medical record department functions, organization of the medical record as a clinical, legal and financial document; ability to interact with co-workers and physicians to resolve coding, documentation and work-flow issues.
• Responsible for safeguarding patient records and ensuring compliance with HIPAA standards.
• Maintains continuing education (CEUs).
• Maintains quality and quantity requirements.

• High School diploma or equivalent
• Registered Health Information Technician (RHIT) preferred or Registered Health Information Administrator (RHIA preferred.
• CCS preferred.

• RHIA (Registered Health Information Administrator) or
• RHIT (Registered Health Information Technician) or
• CCS (Certified Coding Specialist)
• COC (Certified Outpatient Coder)
• CPC
• CCA

• Minimum of 1 year experience in facility outpatient coding.
• Previous experience with 3M encoder.
• Previous experience working with Oracle Cerner EHR.

• Accurately completes ICD-10-CM coding of all documented diagnoses to assure optimal reimbursement, to which Sturdy Health is legally entitled, following approved guidelines and regulations.
• Queries physicians, following AHIMA’s Guidelines for Achieving a Compliant Query Practice.
• Reviews and resolves edits, including NCCI, MUE, and Medical Necessity edits.
• Correctly and appropriately assigns modifiers, when necessary.
• Stays current with reading and demonstrates ability to apply ICD-10-CM Official Guidelines for Coding and Reporting, AHA’s Coding Clinic, AMA’s CPT Assistant, CMS guidelines for modifier application.
• Meets or exceeds both quality and quantity expectations.
• Maintains continuing education and coding credentials.
• Adheres to all remote coding policies and procedures.