POSITION SUMMARY: Responsible for reviewing medical records and translating the information about the patient's visit in to codes for insurance carriers to process claims.

MINIMUM QUALIFICATIONS:

• Evaluates medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit. • Interacts with physicians and other patient care providers in coding admission, principle, and secondary diagnoses and coding principal and secondary procedures to promote appropriate reimbursement. • Interacts with the Insurance Department for timely processing of claims. • Abstracts diagnoses and procedures from medical record into the Physician Health Information System for timely billing. • Evaluates medical records and charge tickets to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-10-CM), and the American Medical Association’s Current Procedural Terminology manual (CPT). • Provides technical guidance and training on medical coding to physicians and staff. • Performs within the prescribed limits of the hospital's/department's Ethics and Compliance program. Detects, observes and reports compliance variances to the department director or upward through the chain of command, the Compliance Officer, or hospital hotline. • Performs related duties as required

Required: • High School Diploma or equivalent. • Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), or other coding certification.

Preferred : Experience in coding for physician and/or provider practice locations and services based on Medical Records documentation.

Some on-location meetings are required - for example, training and IT updates.