Department Overview
This level 3 coding position provides support to the Enterprise Coding Department for coding highly specialized services. The role requires advanced coding experience in highly specialized areas and certification with AAPC or AHIMA.
Function/Duties of Position
Coding at 95% or above accuracy.
Abstract information from patient medical records to assign correct codes to inpatient records, outpatient surgical records, and/or observation cases. Work assigned charge sessions in assigned EPIC charge router work queues.
Depending on posted job need, assign correct CPT, ICD‑10‑CM, HCPCS, or ICD‑10‑PCS and DRGs for facility and/or professional charges, involving complex procedure and diagnostic coding within highly specialized areas such as Inpatient Coding or surgical coding.
Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
Coordinate patient encounter billing information and ensure that all information is complete and accurate before submission. Enter coding and billing information into EPIC, establish and maintain procedures and other controls necessary in carrying out all coding and billing activity.
Resolve billing issues, coding denial requests or questions as part of the coding denial process. Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Centers for Medicare & Medicaid Services (CMS).
Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU, MCMC or Tuality.
Maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orient, and mentor coding staff as necessary.
Department Support
Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support and mentor and orient coding staff as necessary.
Monitor coding and billing information from CMS guidelines, professional licensing organizations, internal communication memos, and transmittals from coding publishers and governmental agencies to advise facility and team of billing practice changes in CPT, ICD‑10‑CM, and HCPCS and ensure changes are implemented to maximize revenue and reflect medical evaluation of patient encounters.
Make recommendations to coding leadership and implement remedial actions for problems.
Attend coding meetings and seminars and share knowledge with other coders. Participate in EC Huddles.
Collaborate with Enterprise Coding Leadership to develop and disseminate written procedures to facilitate and improve billing and documentation processes.
Collaborate with Leadership to make recommendations and implement remedial actions for problems.
Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in CPT, ICD‑10‑CM, and HCPCS.
Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, and stay informed of current trends in coding.
Other duties as assigned.
Required Qualifications
High school diploma or GED.
Minimum of 4 years professional or hospital experience reviewing, abstracting, coding in ICD‑10‑CM or ICD‑10‑PCS, or CPT.
Certification in one of the following coding certifications from AAPC or AHIMA:
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through AHIMA.
Active AHIMA membership may be required for some positions.
Certified Professional Coder (CPC) through the American Academy of Professional Coders; or equivalent certification.
Preferred Qualifications
Accredited Coding Program, Associate's or Bachelor’s Degree; Specialized Coding Credential.
Knowledge of OPPS guidelines and both CPT Inpatient and Outpatient coding guidelines, CCI edits and familiarity with medical necessity guidelines, NCD and LCD requirements.
Experience using an EMR.
Some college coursework or education in anatomy/physiology, medical terminology, CPT and ICD‑10‑CM coding.
Knowledge of CPT Outpatient coding guidelines, CCI edits and familiarity with medical necessity guidelines.
Experience using EPIC, 3M Encoder.
Additional Details
Days of work: Monday‑Friday. Department core hours: Monday‑Friday, 5:00 am‑10:00 pm (with some flexibility available). Regularly scheduled work hours are required and are allowed within the core hours.
This position is eligible for telecommuting.
Benefits
Healthcare for full‑time employees covered 100% and 88% for dependents.
$50 K of term life insurance provided at no cost to the employee.
Two separate above‑market pension plans to choose from.
Vacation: up to 200 hours per year, dependent on length of service.
Sick Leave: up to 96 hours per year.
9 paid holidays per year.
Substantial Tri‑Met and C‑Tran discounts.
Employee Assistance Program.
Childcare service discounts.
Tuition reimbursement.
Employee discounts to local and major businesses.
All are welcome
Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request a reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503‑494‑5148 or aaeo@ohsu.edu.
LinkedIn Job Code
LI‑JG1
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