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Outpatient Coder 2 Certified / PB Coding

Company: William Backus Hospital
Location: Newington
Posted on: June 12, 2021

Job Description:

Work where every moment matters.

Every day, almost 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.

With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

JOB SUMMARY

Reviews and validates outpatient and professional clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical reporting, research, regulatory compliance and reimbursement.

Diagnostic and Procedural Coding/charging responsibility includes but is not limited to the following:

  • Professional Specialty Services
  • Emergency Services
  • Observation
  • Same day surgery
  • Pain Clinic
  • Infusion Services
  • Electrophysiology
  • Cardiac Catheterizations
  • Orthopedic

JOB RESPONSIBILITIES

Coding

  • Applies knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes.
  • Analyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD10CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required.
  • Enters charges for procedures that are not soft coded as instructed for certain patient types
  • Adheres to all department coding/charging procedures, policies, guidelines and quality standards.
  • Complete on a daily basis cases that have been assigned to them utilizing the appropriate work lists.
  • Diagnostic and Procedural Coding/charging responsibility includes but is not limited to the following:
  • Emergency Services
  • Observation
  • Same day surgery
  • Surgical
  • Pain Clinic
  • Infusion Services
  • Electrophysiology
  • Cardiac Catheterizations
  • Orthopedic

  • Assists manager with special projects/other tasks as assigned
  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.

Issue Resolution

  • Review claim edits and revise coding/charging as appropriate for specific range of ICD-10-CM/CPT/HCPCS codes.
  • Review accounts returned from various departments and process corrections for clean claim submission or post claim denial review for appeal.
  • Meet revenue cycle goals (Key Performance Indicators (KPIs)and Productivity Standards)

Communication

  • Seeks clarification from physicians or other staff in cases where documentation is absent, ambiguous, or contradictory
  • Makes corrections based on collaboration with clinician or designee.

Training

  • As assigned, assists in training new coders to become acclimated to the environment and in understanding internal coding policies and procedures, and documentation guidelines.

This position reports to Outpatient or Professional Coding Manager

REQUIREMENTS AND SPECIFICATIONS

Education:

  • Associate's Degree or equivalent experience

Experience

Two to four years of progressive on-the-job experience in an acute care hospital or physician's office. This position is part of the PB Revenue Integrity Team, denials group. The team focus is to review denials from a coding perspective and determine opportunity and assist in recouping payment. This position is focused on financial improvements for HHC. Experience with Accounts Receivable work and insurance EOBs a plus.

Licensure, Certification, Registration

CPC, CPCH, or CCS certification required and maintained thereafter

Knowledge, Skills and Ability Requirements:

Knowledge of:

  • ICD10-CM diagnostic and CPT/HCPCS procedure codes
  • Working knowledge of clinical information
  • Microsoft Office Products; Word, Excel
  • Encoder and/or CAC

Skills:

  • Read, write and speak English proficiently.
  • Solid analytical capabilities.
  • Good organizational skills.
  • Proficiently read and interpret physician writing.

Ability to:

  • Function independently.
  • Handle multiple priorities.
  • Listen and acknowledge ideas and expressions of others attentively.
  • Converses clearly using appropriate verbal and body language.
  • Collaborate with others to achieve a common goal through mutual cooperation.
  • Influence others for positive and productive outcomes.
  • Use independent judgment to solve problems.
  • Ability to work across the Hartford HealthCare System.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

Keywords: William Backus Hospital, New England , Outpatient Coder 2 Certified / PB Coding, Other , Newington, Northeast

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