Out-Patient Surgery Coder-Remote

Memorialcare Health System Fountain Valley , CA 92708

Posted 3 weeks ago

Job Responsibilities and Functions

  • Reviews medical records of all outpatient surgery (including other non-ancillary outpatient accounts) payer types to determine the principal diagnosis and procedure.

  • Utilizes query forms to consult with physician when documentation clarification is necessary

  • Following all regulatory guidelines, utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-9/10 PCS diagnoses and ICD-9/10 CPT procedures

  • Using the International Classification of Diseases (ICD9/10) and the Current Procedural Terminology (CPT) coding classification systems, assigns codes to all diagnoses and procedures following applicable coding principals and department guidelines; enters into the computer coding system

  • Abstracts and codes all required clinical and demographic data for reporting to CMS (Centers for Medicare and Medicaid Services), OSHPD (Office of Statewide Health Planning and Development), Quality Management, and Medical Staff; enters information into the computer abstracting system

  • Maintains current knowledge of the most recent ICD-9-CM/ICD-10 CM/PCS Official Guidelines for Coding and Reporting, the annual changes to the ICD9/10 diagnosis and procedure codes, the annual changes to the inpatient perspective payment system, CPT procedure codes, as well as the quarterly changes to the APC reimbursement system, and the annual changes to the reporting and reimbursement system

  • Demonstrates the ability to accurately and timely code all medical records, including Medicare, to expedite hospital reimbursement, clinical pertinence and indices

  • Demonstrates the ability to take job ownership by offering suggestions and showing a commitment to job completion

Job Specific Competencies

  • Has basic office skills and computer knowledge

  • Communicates effectively with supervisor, peers and others requiring interactions

  • Achieves optimal APC reimbursement

  • Meets facility standards for correct diagnoses and procedure code assignment (ie. accuracy goals)

  • Meets facility standards for QM data/physician assignment/OSHPD required data

  • Meets WAR report productivity goals 97% of the time

Minimum Requirements / Work Experience

  • 3 years ICD-9 coding and APC reimbursement experience in an acute care hospital

  • Expert knowledge of MS-DRG methodology

  • Experience with 3M APR-DRG software

  • Expert knowledge of Severity of Illness and Risk of Mortality methodology

  • Expert knowledge of ICD-10 CM & PCS coding

Education / Licensure / Certification

  • At least one CCS, RHIT or RHIA required
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Out-Patient Surgery Coder-Remote

Memorialcare Health System