Job Summary
Location: Methodist Corporate Office
Address: 825 S 169th St. - Omaha, NE
Work Schedule: Mon - Fri, full-time, flexible 8‑hour daytime shifts
Codes professional charges for surgical procedures for inpatient and outpatient services including correct CPT, ICD‑10‑CM, and modifiers in accordance with medical policies and guidelines.
Responsibilities
Assign ICD‑10‑CM diagnosis, Current Procedural Terminology (CPT) procedure codes, and Healthcare Common Procedure Coding System (HCPCS) device codes as necessary to outpatient records to ensure maximum reimbursement, utilizing ICD‑10‑CM and CPT principles of code assignment and Uniform Hospital Discharge Data Set (UHDDS) definitions of principal and secondary diagnosis.
Accuracy rate of at least 95 %.
Enter ICD‑10‑CM diagnosis code(s) and CPT procedure code(s) into the code summary to maintain disease and operation index, to allow for timely submission of claims to insurance companies by assigning correct diagnosis and procedure codes and the reason for the encounter per department procedure.
Accuracy rate of at least 95 %.
Review CPT and HCPCS device codes in the code summary and charge viewer to ensure all accounts reflect appropriate charges for services and devices provided; review Correct Coding Initiative (CCI) edits, attach modifiers and add or modify charges to the account.
Review hospital billing charges with physicians to ensure accuracy by checking charges and services, answering questions and advising on any insurance billing updates.
Review coding with physician 95 % of the time.
Review per provider request.
Review per departmental audit standards.
Investigate claim denials from third‑party payers to ensure accuracy by reviewing services the patient received and patient account and making any coding/charging corrections.
Compliance with department process: code reviews within 14 days of receipt.
Compliance per request from clinic personnel.
Compliance per request from Business Office and/or Customer Service Personnel.
Ensure timely submission of claims to insurance companies by maintaining accounts receivable within 3 days of discharge on all outpatient encounters. Maintain a minimum productivity standard of:
Codes 7 OPS encounters per hour.
Codes 5 OBS encounters per hour.
Codes 12 Infusion Center encounters per hour.
Codes 10 GI/Pain Management encounters per hour.
Codes 30 Radiology/OP Diagnostic services encounters per hour.
Codes 15 Recurring encounters per hour.
Codes 30 Radiology/OP Diagnostic services encounters per hour.
Codes 25 Non‑patient Pathology encounters per hour.
Codes 15 Emergency Department encounters per hour.
Codes 12 Professional Services encounters per hour.
Utilize and understand how to view and make appropriate changes in charge viewer to ensure maximum reimbursement.
Job Requirements
Education
High School Diploma or General Educational Development (GED) required.
College level completion of courses in anatomy and physiology, biology, disease process, and medical terminology required.
Associate’s Degree in Health Information Management or healthcare related degree preferred.
Participates in mandatory in‑services and continuing education as mandated by policies and procedures, external agencies, and as directed by supervisor.
Experience
3+ years previous experience coding physician services from documentation preferred, surgical and Evaluation/Management (E/M) required.
License/Certifications
Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Registered Health Information Tech (RHIT) or Certified Coding Associate (CCA) or Certified Coding Specialist‑Physician‑based (CCS‑P) required.
Skills/Knowledge/Abilities
Attention to detail when reviewing the medical record, verifying the diagnosis and reviewing charges at the time of ICD‑10‑CM and CPT code assignment.
Understanding of outpatient prospective payment methodology and knowledge of national correct coding initiatives.
Proficiency with a personal computer and Microsoft Office programs.
Experience with Word, Excel, and related applications.
Physical Requirements
Weight Demands
Light work – exerting up to 20 pounds of force.
Physical Activity
Not necessary for the position (0 %): climbing, crawling, kneeling.
Occasionally performed (1 %‑33 %): balancing, carrying, crouching, distinguishing colors, lifting, pulling/pushing, standing, stooping/bending, twisting, walking.
Frequently performed (34 %‑66 %): grasping, reaching, repetitive motions, sitting, speaking/talking.
Constantly performed (67 %‑100 %): fingering/tying, hearing, keyboarding/typing, seeing/visual.
Job Hazards
Chemical agents (toxic, corrosive, flammable, latex).
Biological agents (air‑borne and blood‑borne viruses).
Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps).
Equipment/Machinery/Tools.
Explosives (pressurized gas).
Electrical shock/static.
Radiation (alpha, beta, gamma particles such as X‑ray, CT, gamma knife).
Radiation non‑ionizing (ultraviolet, visible light, infrared, microwaves).
Mechanical moving parts/vibrations.
Equal Opportunity Employer Statement
Nebraska Methodist Health System is an affirmative action/equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.
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