HIM Professional Services Coder II - Offsite . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Professional Services Coder II under direct supervision 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, 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 II 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. Major Responsibilities: Review Medical Records to resolve Ingenix and HealthConnect Coding Edits Under supervision, identify and resolve coding related edits by reviewing the medical record and ensuring that all data and codes are consistent with ICD-9-CM Official Guidelines, CPT, CPT Assistant, CMS, OMFS, MediCal, USDOL, as well as Regional and Local policies Correct data as appropriate Review Medical Records to identify diagnoses/procedures Under supervision, 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 Work Experience: Minimum of two, of the last three years, continuous professional coding/abstracting experience and passing score of 95% on the Professional Services Coding teat for a Professional Services Coder II position Functional/Technical Knowledge & Skills: Must be able to meet production and quality standards established for a Professional Services Coder II Demonstrated knowledge of Anatomy and Physiology, medical terminology, 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. Education/Training: Completion of classes in medical terminology, anatomy and physiology, ICD-9-CM, CPT and HCPCS coding conventions, and disease process from and accredited program is required Must have High School diploma or GED License/Certification: Current certification as a Certified Professional Coder (CPC) or Certified Coding Specialist for Professional Services (CCS-P)
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