Senior Outpatient Coder ED/ Profee and Facility

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

Responsible for assigning diagnostic and procedural codes (outpatient surgery, observation, infusion services, and interventional procedure records) to patient charts of moderate to high complexity using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Coding: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA).
• Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition.
• Coding Quality: Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by per facility.
  • Goal: Average coding quality standard of =/>95% accuracy per monitoring period.
  • Does not meet =<95% accuracy
  • Meets => 95% accuracy
  • Exceeds =>95.01% accuracy
  • Coding Labor Productivity: Meets and/or exceeds Conifer’s coding productivity guidelines.
• Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding. Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-10-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls
• Communicates and resolves coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Proficient in outpatient diagnosis coding guidelines
• Proficient in CPT/HCPCS code assignment including Evaluation & Management facility coding guidelines
• Ability to assign corresponding PCS codes (after dates of service 10/1/2014)
• Working knowledge of the Outpatient Prospective Payment System (OPPS)
• Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager
• Ability to establish and maintain effective working relationships as required by the duties of the position
• Ability to concentrate and accomplish tasks with explicit accuracy
• Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency
• Functional knowledge of facility EMR, encoder and other support software

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• One year of experience performing medical record coding in acute care setting preferred
• High school graduate or equivalent is required
• Completion of basic coding course (academic, seminar, workshop or facility-based), including medical terminology and basic anatomy and physiology, or an equivalent combination of education and experience also required

CERTIFICATES, LICENSES, REGISTRATIONS

• Required: AHIMA or AAPC approved credential

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to work in sitting position, use computer and answer telephone
• Ability to travel
• Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Office Work Environment
• Hospital Work Environment

OTHER

• Must be able to travel nationally as needed, not to exceed 10%

Compensation and Benefit Information

Compensation

• Pay: $22.56-$33.85 per hour.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.