Remote
Position Summary:
The Hospital Outpatient Coder, under general direction, is responsible for critical access hospital coding; including emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic. They will ensure the timely and accurate coding of medical claims while maximizing reimbursement for services.
Qualifications:
Education and/or Experience:
• High School Diploma or GED - required
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) - required
• Three to five years in emergency room coding, infusion coding, specialty clinic procedure coding - preferred | Two years’ experience with formal coding training - considered
Licenses/Certifications Required:
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.
General Requirements/Job Duties:
Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Specific job duties will vary based upon client assignment. Employee will also abide by ruralMED’s policies as a condition of employment.
Charge Entry
- Receive and review charge entry data from practice sites
- Identify and investigate incomplete or missing charges
Coding:
- Abstract clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems
- Sequence codes according to established guidelines
- Thorough analysis and interpretation of medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement
Other:
- Maintain current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers
- Maintain proficient knowledge of EHR, as well as any other systems to perform job duties
- Communicate issues to management, including payer, system, or escalated account issues
- Identify medical necessity denial trends and provide suggestions for resolution
- May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution
- Participation in department meetings, in-service programs, and continuing education programs
- Convey professional attitude with patients, visitors, physicians, office staff and hospital personnel
- Assure confidentiality of patient information, maintaining compliance with policies and procedures
- Perform other duties as assigned
Required Knowledge, Skills and Abilities:
- Knowledge of medical terminology – required
- Critical Access Hospital and/or Rural Health Clinic coding is a plus
- Proficient with Microsoft Office
- Demonstrated strong verbal and written communication skills
- Ability to use multiple client systems and manage competing priorities
- Enthusiasm for a remote teamwork environment
Security/Access:
Equipment Used:
Patient Age Groups Served:
None.
Essential Work Environment & Physical Requirements:
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.
