Senior Hospital Outpatient Coder (Radiation Oncology)

Description

The Outpatient Coder-Senior is responsible for conducting the quality review of outpatient coding, assuring coding compliance with federal regulations, and maintaining up-to-date coding guidelines and coding policy changes. Reviews, interprets, and assigns diagnostic and procedural codes based on medical record documentation according to correct coding principles. Knowledge of edit resolution and ability to code complex OP encounters. Assists in mentoring and training new coders on workflows and applications. Preserves the confidential nature of the information. Supports and maintains UT Health San Antonio policies, protocols, and values. Works under the general supervision of the Coding Operations Manager in a hospital setting.

Responsibilities

1. Interact and communicate effectively with coding team members, CDI, quality, and other external departments.

2. Participates and provides feedback during department meetings and education services.

3. Share knowledge with the coding team and appropriate external departments.

4. Assists department team members in researching and resolving coding challenges.

5. Examines and interprets documentation from medical records and completes accurate ICD-10-CM and CPT code assignment of diagnoses and procedures using an electronic encoder application and electronic medical record.

6. Abstracts administrative and clinical data from the electronic medical record for secondary use.

7. May assist with coding emergency, ancillary, recurring or HOPD patient encounters when necessary. Entering facility charges when necessary.

8. May collect and prepare data for management review.

9. May coach OP Coders on OP coding practices.

10. Initiates queries with providers to obtain or clarify documentation as appropriate.

11. Works from a coding queue, completing and re-assigning accounts correctly.

12. Assists in coding reviews and second level reviews as needed.

13. Adheres to strict federal coding rules in selecting codes that appropriately reflect conditions and treatment.

14. Balances need for accuracy against timely completion for billing deadlines.

15. Supports meeting organizational unbilled goals for Accounts Receivable with uncoded accounts.

16. Performs all aspects of daily work in a manner that contributes to and ensures an environment of strict confidentiality.

17. Performs all other duties as assigned.

Qualifications

Knowledge of Official Guidelines for coding and reporting. Knowledge of medical terminology, human anatomy, physiology and pharmacology.

Knowledge of disease pathology Knowledge of Current Procedural Terminology coding (CPT), ICD-10-CM, and Healthcare Common Procedure Coding System (HCPCS)

Ability to code surgical and observation patient encounters.

Knowledge of operating ordinary business equipment in a remote and office environment such as computer, keyboard, telephone.

Ability to work effectively in and navigate between common office software, coding software, billing software and abstracting systems.

Knowledge of coding resources and demonstrated proficiency in using resources.

Ability to troubleshoot basic technical issues in the remote and office environment.

Education:

High School Diploma required

Certification and Licensure:

Accreditation from a professional coding organization, such as American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC). RHIT, RHIT, CCS, CCA, CPC, COC, CIC, and/or CPMA