Department of Medicine Coder; Coding Specialist ll

Overview

This level 2 coding position provides support to the Enterprise Coding Department for coding of physician’s fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA.

• For Professional Services coding positions: review clinical documentation and apply the correct coding and modifiers to evaluation and management services and non-surgical procedural services. Ensure that the documentation supports the levels or types of service billed, is in compliance with Medicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentation and CMS coding guidelines.
• For Facility Services coding positions: review documentation of outpatient diagnostic and ancillary services for diagnostic radiology, pathology, and other ancillary facility services vide support to the Enterprise Coding Department for abstracting of records, coding, and charge router submission of Facility services rendered at OHSU.
• Meet performance standards for accurate and timely submission of charges and coding for professional and facility services rendered at OHSU.
• Collaborate with Enterprise Coding Leadership and billing departments to provide technical expertise regarding a broad range of third-party payer and reimbursement issues.
• Orient peer coders or new hires to specified coding assignments.
• Maintain an hourly productivity standard and quality standards as set by Enterprise Coding and based on industry standards.
• Attend Enterprise Coding and Clinical Department meetings via conference call and Webex.
• Code Work Queue assignments will vary based on business needs or management assignments.

Coding:

• Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with CMS.
• Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E/M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry.
• Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU.
• Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance Program (OMAP).
• Coordinate all billing information and ensure that all information is complete and accurate.
• Maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
• Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orientate, and mentor coding staff as necessary.

• Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
• Attend coding meetings and seminars and share knowledge with other coders. Participate in EC Huddles.
• Collaborate with Enterprise Coding Leadership to develop and disseminate written procedures to facilitate and improve billing and documentation processes.
• Collaborate with Leadership to make recommendations and implement remedial actions for problems.
• Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in CPT, ICD-10-CM, and HCPCS.
• Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, and stay informed of current trends in coding.

Perform other duties as assigned.

• High School diploma or GED.
• Minimum two years of hospital or professional services (dependent on position) experience reviewing, abstracting, and coding medical records using ICD-10-CM and CPT coding.
• Coding certification from AAPC or AHIMA:
• Registered Health Information Administrator (RHIA)
• Registered Health Information Technician (RHIT)
• Certified Coding Specialist (CCS) through the…