Overview

Coder 2s analyze clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient visits, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM, CPT-4, and HCPCs Coding Classification systems. Utilizes an electronic coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Coder 2’s also resolves clinical documentation and charge capture discrepancies and provides feedback to providers on the quality of their documentation and charging.

Responsibilities Job Description

Job Expectations:

• Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards.

• Actively participates in creating and implementing improvements.

• Assigns ICD-10, CPT-4, and HCPCs codes to all diagnoses, treatments, and procedures, according to official coding guidelines.

• Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned.

• Extracts required information from electronic medical record and enters encoder and abstracting system.

• Follows-up on unabstracted accounts to assure timely billing and reimbursement.

• Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. May query physicians on documentation according to established procedures and guidelines.

• Meets departmental productivity and quality standards

• Complete projects as assigned.

• Performs other responsibilities as needed/assigned.

• Timely and accurate work

• Contributes to the process or enablement of collecting expected payment

• Understands and adheres to Revenue Cycle’s Escalation Policy.

Organization Expectations, as applicable:

• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served

• Partners with patient care giver in care/decision making.

• Communicates in a respective manner.

• Ensures a safe, secure environment.

• Individualizes plan of care to meet patient needs.

• Modifies clinical interventions based on population served.

• Provides patient education based on as assessment of learning needs of patient/care giver.

• Fulfills all organizational requirements

• Completes all required learning relevant to the role

• Complies with and maintains knowledge of all relevant laws, regulations, policies, procedures, and standards.

• Fosters a culture of improvement, efficiency, and innovative thinking.

• Performs other duties as assigned

Qualifications

Minimum Qualifications to Fulfill Job Responsibilities:

Required:

Education

• Certificate program in coding or associate degree in HIM or a certificate with 1-3 years of healthcare experience (MA, HUC, Revenue Cycle)

Experience

• 1 year experience required if appropriate coursework has been completed

License/Certification/Registration

• One of the following must be obtained within 1 year of hire:

• Outpatient or Professional Fee Coding: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist – Professional (CCS-P), Certified Professional Coder - Hospital (CPC-H) COC – Certified Outpatient Coder

• None if graduate of a program or associate degree, 1-3 years of healthcare experience (MA, HUC, Revenue Cycle) with a certification

Preferred

Education

• Associates or bachelor’s degree

Experience

• At least one year of coding experience

License/Certification/Registration

• One of the following:

• Outpatient or Professional Fee Coding: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist – Professional (CCS-P), Certified Professional Coder - Hospital (CPC-H) COC – Certified Outpatient Coder

• Additional Requirements Basic knowledge of Windows-based computer software. Epic and Microsoft Teams. Due to differences in scope of care, practice, or service across settings, the specific experience required for this position may vary.

EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

Compensation Disclaimer

An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical.