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Outpatient Coder III - HF Coding and Documentation
Health First • Remote • Posted 30+ days ago
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Remote • Full-time • Mid Level
Job Highlights
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The Outpatient Coder III at Health First is responsible for providing timely, complete, and accurate data collection for quality clinical analysis and revenue enhancement. This role involves maintaining patient confidentiality, interpreting clinical documentation to ensure code accuracy, and maintaining coding accuracy in accordance with coding and compliance guidelines. The position is fully remote, with the majority of work being conducted from home.
Responsibilities
- Maintain and observe patient confidentiality as outlined in the National Patient Safety Goals and HIPAA guidelines.
- Knowledge of regulatory environment and legislation related to code assignment changes, local coverage determinations, and national coverage determinations.
- Ensure all work areas and equipment are in safe and working condition.
- Literacy and proficiency in computer technology and Health Information/Coding applications.
- Interpret clinical documentation to ensure codes are clearly and consistently supported by the health record.
- Maintain coding accuracy as per departmental standards.
- Notify medical records/registration personnel of any identified discrepancies of patient information in the medical record.
- Knowledge of structure and content of the electronic health record and competency to navigate the EHR accurately and efficiently.
- Attend department meetings, coding roundtables, and departmental educational opportunities.
- Earn 7 CEU's yearly related to coding profession.
- Review Coding Clinic for ICD 10 quarterly updates and complete coding clinic quizzes.
- Provide professional and courteous communication to customers, families, physicians, other associates, and leadership.
- Respond and relay documentation/coding issues and concerns from and to Health First departments and physician's offices.
- Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
- Maintains productivity standards according to departmental guidelines.
- Meets discharged not final coded (DNFC) departmental goals.
- Responds timely to pre-bill edits ensuring a prompt turn-around-time to assist in facilitating an efficient revenue cycle.
- Analyze and reply to denial management issues presented identifying documentation concerns and validating accuracy and completeness in code assignment.
- Provide departmental coding coverage by cooperating with occasional schedule revisions and overtime requests when staffing needs arise.
- Accountable and dependable time and attendance record to ensure daily workflow and departmental productivity guidelines are met.
Qualifications
Required
- High School Diploma
- 3 years outpatient coding experience
- Knowledge of ICD-10 CM/PCS and CPT-4 Official Coding Guidelines
- Awareness of AMA Coding Clinics for ICD10, AMA Coding Clinic for HCPCS, AMA CPT Assistant, National Correct Coding Initiative edits, National and Local Coverage Determinations
- Medical terminology knowledge
- Anatomy and physiology knowledge
- Computer Applications knowledge
Preferred
- Certification (AHIMA or AAPC)
- 4 years outpatient coding experience
- Successful completion of internal outpatient coding assessment with passing score of at least 85%
About Health First
Healthfirst is a leading health insurance brand in New York, offering affordable and comprehensive health insurance plans, Medicare Advantage plans, and long-term care plans. They also provide coverage for COVID-19 testing and vaccination, as well as support resources during the pandemic. With a commitment to providing access to healthcare for all, Healthfirst has become the largest not-for-profit health insurer in the state, serving a diverse range of individuals and families.
Full Job Description
**Candidate to be considered must reside in the state of Florida. This is a work from home opportunity with majority being remote work**
*Position Summary*
To be fully engaged in providing timely, complete, and accurate data collection for quality clinical analysis and revenue enhancement.
*Primary Accountabilities*
1. Maintain and observe patient confidentiality as outlined in the National Patient Safety Goals and HIPAA guidelines protecting the confidentiality of the health record at all times and refuse to access protected health information not required for coding-related activities.
2. Knowledge of the regulatory environment and legislation related to code assignment changes, local coverage determinations, and national coverage determinations.
3. Ensures that all work areas and equipment, whether remote or on-site, are in safe and working condition.
4. Literacy and proficiency in computer technology and Health Information/Coding applications needed for departmental efficiency and job performance.
5. Interpret clinical documentation to ensure codes reported are clearly and consistently supported by the health record.
6. Maintain coding accuracy as per departmental standards-approving, editing, and assigning ICD 10 and CPT-4 codes in the computer assisted coding application based on physician documentation in accordance to coding and compliance guidelines.
7. Notification to medical records/registration personnel of any identified discrepancies of patient information in the medical record.
8. Knowledge of structure and content of the electronic health record displaying ability and competency to navigate the EHR accurately and efficiently for data quality collection and code assignment and other required abstraction.
9. Attends department meetings, coding roundtables, and departmental educational opportunities.
10. Earn 7 CEU's yearly related to coding profession.
11. Review Coding Clinic for ICD 10 quarterly updates and complete coding clinic quizzes.
12. Excellent communication, problem solving and critical thinking skills.
13. Provide professional and courteous communication to customers, families, physicians, other associates, and leadership at all times.
14. Respond and relay documentation/coding issues and concerns from and to Health First departments and physician's offices in a polite and considerate demeanor, utilizing the highest standard of customer services skills.
15. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
16. Always displays professionalism and respect; every person, every time
17. Maintains productivity standards according to departmental guidelines.
18. Meets discharged not final coded (DNFC) departmental goals.
19. Responds timely to pre-bill edits received ensuring a prompt turn-around-time to assist in facilitating an efficient revenue cycle.
20. Analyze and reply to denial management issues presented identifying documentation concerns and validating accuracy and completeness in code assignment.
21. Provide departmental coding coverage by cooperating with occasional schedule revisions and overtime requests when staffing needs arise.
22. Accountable and dependable time and attendance record to ensure daily workflow and departmental productivity guidelines are met.
*MINIMUM QUALIFICATIONS*
· Education: High School Diploma
· Work Experience: 3 years outpatient coding experience.
· Licensure: N/A
· Knowledge/Skills/Abilities:
· ICD-10 CM/PCS and CPT-4 Official Coding Guidelines
· AMA Coding Clinics for ICD10, AMA Coding Clinic for HCPCS, AMA CPT Assistant, National Correct Coding Initiative edits, National and Local Coverage Determinations
· Medical terminology
· Anatomy and physiology
· Computer Applications
*PREFERRED QUALIFICATIONS*
Certification (AHIMA or AAPC)
4 years outpatient coding experience
Successful completion of internal outpatient coding assessment with passing score of at least 85%.
*PHYSICAL REQUIREMENTS*(ADA, Travel, Environment, Noise)
1. Ability to sit at a computer for extended periods of time.
2. Visual acuity and ability to view computer screen for extended periods of time.
3. Ability to enter data using hand/wrist dexterity.
**Job:** **Medical Coding*
**Organization:** **Health First Shared Svcs Inc*
**Title:** *Outpatient Coder III - HF Coding and Documentation*
**Location:** *Florida - Brevard County-Melbourne*
**Requisition ID:** *071401*
*Position Summary*
To be fully engaged in providing timely, complete, and accurate data collection for quality clinical analysis and revenue enhancement.
*Primary Accountabilities*
1. Maintain and observe patient confidentiality as outlined in the National Patient Safety Goals and HIPAA guidelines protecting the confidentiality of the health record at all times and refuse to access protected health information not required for coding-related activities.
2. Knowledge of the regulatory environment and legislation related to code assignment changes, local coverage determinations, and national coverage determinations.
3. Ensures that all work areas and equipment, whether remote or on-site, are in safe and working condition.
4. Literacy and proficiency in computer technology and Health Information/Coding applications needed for departmental efficiency and job performance.
5. Interpret clinical documentation to ensure codes reported are clearly and consistently supported by the health record.
6. Maintain coding accuracy as per departmental standards-approving, editing, and assigning ICD 10 and CPT-4 codes in the computer assisted coding application based on physician documentation in accordance to coding and compliance guidelines.
7. Notification to medical records/registration personnel of any identified discrepancies of patient information in the medical record.
8. Knowledge of structure and content of the electronic health record displaying ability and competency to navigate the EHR accurately and efficiently for data quality collection and code assignment and other required abstraction.
9. Attends department meetings, coding roundtables, and departmental educational opportunities.
10. Earn 7 CEU's yearly related to coding profession.
11. Review Coding Clinic for ICD 10 quarterly updates and complete coding clinic quizzes.
12. Excellent communication, problem solving and critical thinking skills.
13. Provide professional and courteous communication to customers, families, physicians, other associates, and leadership at all times.
14. Respond and relay documentation/coding issues and concerns from and to Health First departments and physician's offices in a polite and considerate demeanor, utilizing the highest standard of customer services skills.
15. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
16. Always displays professionalism and respect; every person, every time
17. Maintains productivity standards according to departmental guidelines.
18. Meets discharged not final coded (DNFC) departmental goals.
19. Responds timely to pre-bill edits received ensuring a prompt turn-around-time to assist in facilitating an efficient revenue cycle.
20. Analyze and reply to denial management issues presented identifying documentation concerns and validating accuracy and completeness in code assignment.
21. Provide departmental coding coverage by cooperating with occasional schedule revisions and overtime requests when staffing needs arise.
22. Accountable and dependable time and attendance record to ensure daily workflow and departmental productivity guidelines are met.
*MINIMUM QUALIFICATIONS*
· Education: High School Diploma
· Work Experience: 3 years outpatient coding experience.
· Licensure: N/A
· Knowledge/Skills/Abilities:
· ICD-10 CM/PCS and CPT-4 Official Coding Guidelines
· AMA Coding Clinics for ICD10, AMA Coding Clinic for HCPCS, AMA CPT Assistant, National Correct Coding Initiative edits, National and Local Coverage Determinations
· Medical terminology
· Anatomy and physiology
· Computer Applications
*PREFERRED QUALIFICATIONS*
Certification (AHIMA or AAPC)
4 years outpatient coding experience
Successful completion of internal outpatient coding assessment with passing score of at least 85%.
*PHYSICAL REQUIREMENTS*(ADA, Travel, Environment, Noise)
1. Ability to sit at a computer for extended periods of time.
2. Visual acuity and ability to view computer screen for extended periods of time.
3. Ability to enter data using hand/wrist dexterity.
**Job:** **Medical Coding*
**Organization:** **Health First Shared Svcs Inc*
**Title:** *Outpatient Coder III - HF Coding and Documentation*
**Location:** *Florida - Brevard County-Melbourne*
**Requisition ID:** *071401*
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