Outpatient Coder Specialist; Maui Health

Job Summary

Under supervision, is responsible for assigning accurate diagnosis and procedure codes to the patients' health information records, for:
Observation, Hospital Ambulatory Surgery, Complex Hospital Outpatient Visit {Cardiac Catheterization (Percutaneous Coronary Intervention) Lab, Interventional Radiology}, Emergency Departments, and other select OP records. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions and procedures; utilizing various coding classification schemes including ICD-10-CM (may include PCS), and HCPCS/CPT.

All work will be carried out in accordance with the:
International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS);
American Medical Association (CPT) National Correct Coding Initiative (NCCI), and Kaiser Permanente organizational/institutional coding directives. Ability to communicate with physicians in order to obtain clarification for diagnoses/procedures. Ability to understand the clinical content of the health record and abstract the data in the patient health information record data as well as perform other duties as assigned.

• Upholds and maintains Maui Health Systems Policies and Procedures, Principles of Responsibilities and all applicable state, federal and local laws.
• Reviews patient health information record to identify and assign appropriate codes for diagnoses, procedures, and other services rendered.
• Appropriately assign and sequence codes for diagnoses, procedures and other services as needed for proper Ambulatory Payment Classification (APC) assignment, utilizing the applicable coding conventions.
• Serves as a consultant to care providers.
• Identifies discrepancies, potential quality of care, and billing issues.
• Research, analyzes, recommends and facilitates plan of action to correct discrepancies and prevent future coding errors.
• Interacts with physicians through established query process in order to clarify documentation supporting accurate patient diagnostic and procedure coding.
• Abstracts patient information into the computerized systems, in a manner ensuring the accuracy and integrity of the data.
• Ensures timely coded record availability according to regulatory guidelines, by meeting established coding and abstracting productivity standards.
• Ensures quality standards by meeting the established 95% coding accuracy and 98% completeness quality standards.
• Maintains and complies with HIPAA policies and procedures for privacy and confidentiality of all patient records.
• Attends and participates in selected national, regional and coding educational sessions.
• Works collaboratively with others on coding questions and issues.
• Demonstrates knowledge of system security, by complying with KP Electronic Assets Usage Policy.
• Maintains courteous and cooperative relations when interacting with others.
• Performs other duties as assigned.

Must relocate to state of Hawaii before date of hire, Opportunity to work onsite, hybrid or remote.

Basic Qualifications:

• Minimum one (1) year of Certified Coding experience.

• High school diploma or General Education Diploma (GED) required.
• Post high school coursework in medical records administration, anatomy, physiology and medical terminology.

• Certified Coding Specialist OR Registered Health Information Technician OR Registered Health Information Administrator OR Certified Professional Coder

• Demonstrated competence with personal computers, networks, and Microsoft Office.
• Experience with International Classification of Diseases (ICD-10), Current Procedure Terminology (CPT4), and Healthcare Common Procedure Coding System (HCPCS) coding system, and other related documentation requirements.
• Demonstrated ability to understand clinical content of a health record.

• Minimum three (3) consecutive years of experience as a Certified Hospital Coder.
• Previous experience of coding in a hospital license space.
• Successful completion of Certified Coding Specialist Program through American Health Information Management Association (AHIMA).

• Entry level

• Full-time

• Health Care Provider

• Hospitals and Health Care