[Hiring] Outpatient Coder I @Yale New Haven Health

Role Description

Under the general direction of the OP Coding Supervisor, the Outpatient Coder 1 is responsible for a comprehensive review of medical record documentation and performs a variety of coding related activities in one complex outpatient coding service line. Work may include, but is not limited to:

• Coding cases
• Prioritizing assigned coding tasks
• Resolving claim edits
• Handling individual coding workload
• Working stop bills (if assigned)
• Sending queries, as needed, to clinical staff

EEO/AA/Disability/Veteran

• Reviews medical record documentation to determine appropriate ICD-10-CM codes in accordance with official coding guidelines.
• Reviews medical record documentation and accurately selects the appropriate CPT codes, modifiers, and ICD-10-PCS, when applicable, in accordance with official coding guidelines. This includes resolving CCI edits, as applicable.
• Maintains a minimum of 95% overall coding quality score in diagnostic, procedural, and modifier code selection.
• Maintains the productivity expectations as defined by the department for the coding service line.
• Capable of coding a minimum of one complex OP service line, which would include: Cardiology, Interventional Radiology, Observation, Oncology, or Same Day Surgery at proficiency.
• Participates and seeks out career development activities by reading journals, coding articles, researching procedures and/or disease processes to ensure appropriate code selection, regularly attends coding education sessions, and actively participates in learning circles.
• Uses department resources regularly and follows workflows, with minimal assistance or intervention, to perform daily work to meet CFB (candidate for billing) goals.
• Resolves cases returned coder for education and/or errors, and uses feedback to improve ongoing performance.
• Handles coding DNBs and stop bills (if assigned), or other projects and/or coding initiatives as assigned.
• Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures.
• Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and vision of the department.

Qualifications

• Bachelors degree preferred. Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process.
• Requires a minimum of 2 years of outpatient or professional coding experience in a complex service line. Coding experience may be partly substituted for a college degree with an RHIT/RHIA credential or CCS/CCS-P coding credential. Prior experience in Epic and 3M encoder is preferred.
• CCS, CCS-P, or RHIT credential preferred. Must possess a valid coding credential through AAPC and/or AHIMA. CPC-A or CCA not accepted.
• Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM/PCS, and CPT coding with the ability to acclimate and apply knowledge in a fast-paced OP Coding department setting.
• Knowledge of professional E/M leveling preferred.
• Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills.
• Must be able to perform functions independently and under limited supervision.

Company Description