PB Coder – Outpatient

Position: PB Coder 2 – Outpatient
Charlestown, MA
• Beth Israel Lahey Health
• Full-time
• Day When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic.

The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing.

Job Description:

Essential Duties & Responsibilities including but not limited to:

Professional Coding Coding Responsibilities:
· Provides review and/or coding of any professional services including but not limited to surgeries and diagnostic services for appropriate use of CPT, ICD-10 – CM, HCPCS, and Modifier usage/linkage as well as provide ICD-10- CM coding where needed for missing diagnoses.
· Productivity and accuracy standards must be met according to guidelines set by the manager.
· Prospective audit of charges entered by providers as well as provide feedback to providers
· Periodic review of codes, at least annually or as introduced or required for new, revised, or deleted code updates.
· Answers and responds accurately and timely to questions from providers and other departments
· Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding when necessary
· Reports regularly on findings of reviews/rejections as required by the manager.

Physician/Provider

Education:

· Confers regularly with physicians/other qualified health care providers, clinical or ancillary managers, coders, or other staff through departmental staff meetings, one-on-one meetings, and/or daily interactive communication to respond to and educate providers on specific departmental and clinic-wide coding issues and updates.
· Participates in new physician/care provider orientation as well as provides follow-up reviews and education for the new physician/care provider if applicable for the area of responsibility.
· Provides feedback, recommendations, and participates as the coding representative for the Professional Coding Department on the Revenue Cycle Teams as requested by the manager.
· Develops and conducts a schedule of physician/care provider documentation reviews in areas where applicable and/or as defined by the manager.
· Provides feedback to the physician/other qualified health care provider, Department Chair, and/or Administration as required.
· Documentation review is ongoing and feedback will be provided to the physician/ other qualified health care provider, Department Chair, and/or Administration as required.

Minimum Qualifications:

Education:

Professional Coding
· High School Diploma or equivalent, plus additional specialized training associated with the attainment of a recognized Coding Certificate.

Licensure, Certification & Registration:

Professional Coding
· CPC (Certified Professional Coder through the American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through the American Health Information Management Association)

Experience:

· Minimum 2 years of ICD-10-CM, CPT/HCPC Outpatient coding assignment, required
· Microsoft Office applications
· Interventional Radiology, Cardiac Cath, Injection and Infusion, Observation, and…