HIM Professional Services Coder
Located in Anaheim, California, the Professional Services Coder is responsible for accurate coding of professional services (diagnoses, conditions and procedures) from medical record documentation for hospital services. Working from the appropriate documentation in the medical record, this role assigns codes and modifiers with ICD-9-CM, CPT and HCPCS Level II codes when appropriate. All work is performed in accordance with the rules, regulations and coding conventions of ICD-9-CM Official Guidelines for Coding and Reporting, Coding Clinic published by the American Hospital Association, the ICD-9-CM, CPT and HCPCS code book, CPT Assistant, NCCI Edits, OSHPD and organizational and institutional coding guidelines. A Professional Services Coder assigns codes for professional services rendered in the following settings: Hospital, Emergency Department (ED), Hospital Observation (HOPS), Hospital Ambulatory (HAS), Hospital Outpatient (HOV) and Medical Office. Duties: * Review Medical Records to identify diagnoses/procedures * Codes all diagnostic and operative information from the medical record using ICD-9-CM, CPT and HCPCS coding classification systems * Verifies and abstracts all medical data from the record to assign appropriate codes * Corrects data as appropriate * Review medical records to resolve coding edits * Identify and resolve coding related edits by reviewing the medical record and ensuring that all data and codes are consistent with guidelines Specific Requirements (required unless noted otherwise): * Completion of classes in Medical Terminology, Anatomy/ Physiology, ICD-9 and CPT coding conventions conforming to standards established by the American Hospital Association (Coding Clinic), American Medical Association, CMS, or successful completion of an AAPC or AHIMA accredited coding certification program * Ability to understand the clinical content of a health record * Ability to effectively communicate with physicians and other healthcare providers * Ability to perform within acceptable established quality standards * Ability to meet production and quality standards established for a Professional Services Coder II * Demonstrated knowledge of anatomy and physiology, medical terminology, and disease processes * Basic knowledge of reimbursement methodologies and conventions * Knowledge of rules and guidelines for current coding classifications * Demonstrated ability to understand the clinical contents of a health record * Demonstrated ability to communicate with physicians in order to clarify diagnoses and procedures coding and documentation requirements, including proper sequencing * Must maintain current coding credential and perform associated Continuing Education Units Industry Knowledge * Working knowledge of hospital and/or physician clinic based revenue cycle * Working knowledge of professional services coding and billing in a multi-specialty environment * Working knowledge of government and other payer coding, billing and collection rules and regulations
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