Ambulatory Procedure Visit-Outpatient Coder

Ambulatory Procedure Visit-Outpatient Coder

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Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently has a contract with the Federal Government. You would be a W-2 employee for HPMG and NOT a government employee.

Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for ambulatory procedure visits. Trains and educates MTF staff on coding issues and plays a significant role in departmental and clinic-wide coding compliance activities.

• Position requires excellent computer/communication skills for provider and staff interactions.
• Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient and ambulatory surgery), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience.
• Candidate must have ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.

• Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM);
  Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT), as used in institutional and professional services medical coding.
• Advanced knowledge of reimbursement systems, including Prospective Payment System (PPS);
  Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
• Advanced knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
• Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to: Laboratory, Dental, Occupational Therapy, Physical Therapy, and Radiology); and revenue cycle management concepts related to medical coding.
• Practical knowledge and understanding of Government rules and regulations regarding medical coding, reimbursement guidelines and healthcare fraud; commercial reimbursement guidelines and policies; coding audit principles and concepts, and potential areas of risk for fraud and abuse. Includes, but not limited to:
  The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage Determinations and National Coverage Determinations (LCD and NCD), National Correct Coding Initiative (NCCI) guidance, manual, and edits, Internet-Only Manuals (IOMs), and HHS-OIG publications and reports.
• Practical knowledge of clinical documentation improvement and continuous process improvement processes.
• Practical knowledge of EHR systems and workflows pertaining to medical coding.

The following are recognized certifications:
Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Coder Specialist (CCS), Certified Coder Specialist – Physician (CCS-P) are preferred for outpatient/ambulatory surgery medical coders.

A Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA) from AHIMA may be counted towards either the professional services or institutional coding certification requirement, but NOT both, unless the individual possesses the required institutional and professional services experience for the specific position sought.

The E&M coding certifications requirement for a Certified Evaluation and Management Coder (CEMC), or National Alliance of Medical Auditing Specialists’ (NAMAS) Certified Evaluation and Management Auditor (CEMA), are waived for personnel in this contract.

Coding certifications other than those listed will be considered by the government on a case-by-case basis.

Medical coders will obtain the required continued education hours to maintain the current…