Hospital Outpatient Coder

Title: Hospital Outpatient Coder 

Department: Revenue Cycle Resources 

Status: Full-Time 

Locations: Remote within Nebraska, Kentucky, Missouri, Pennsylvania, New Mexico, Kansas, Tennessee 

Note: A Coding Competency Assessment Test will be provided for qualified applicants prior to their first interview 

Hello, We Are ruralMED! 

Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise. 

When you join our team as a Hospital Outpatient Coder, you are not just responsible for providing timely and accurate coding of our client’s outpatient medical claims, you get to play a vital role in supporting rural hospitals and the communities they serve. You will ensure maximum reimbursement for services that our clients provide by utilizing your sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.  

How This Role Makes an Impact: 

• Utilizing your knowledge and skill set, you will experience the rewarding satisfaction of supporting hospitals on their journey to thrive within the evolving landscape and achieve excellence. 
• You will work alongside a team of dedicated and driven experts who are passionate in supporting each other in being the best at supporting rural healthcare with their coding prowess.  
• Applying your problem-solving and critical thinking skills, you will be empowered to take ownership and to think outside of the box to develop processes and workflows that continue to further enhance our efficacy and accuracy.  
• You will play a direct role in being a “Coding Hero” by helping hospitals maximize their reimbursement, and support their patients by making sure payors don’t have an excuse to not pay.   

What It’s Like Working at ruralMED: 

• Our elite and highly-skilled team is driven by delivering top-notch results and supporting each other to reach a new level of excellence to make an impact for our clients and rural healthcare. 
• Discover flexibility and autonomy with a company that understands the true value and benefits of work-life balance. 
• Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool to achieving brilliance. 
• Our core values are not only motivational, but they are also the standard for how we conduct and take pride in our work. 

• It Begins With You: Own it. 
• Pave the Way. Never Settle. 
• Be Thoughtful. Be Transparent. Be Extraordinary.  
• Work Fearlessly. Celebrate the Wins.  
• Capitalize Our Strengths. Achieve Excellence.  

• Learn more about our team: https://ruralrevcycle.com/join-our-team/ 

How to Succeed in this Role: 

• Excellent Analytical, Critical Thinking, and Problem-Solving skills 
• 3-5 years of related coding experience (required). 
• Ability to take direction and work independently. 
• Strong communication and collaboration skills.  
• Possess Advanced Coding Skills 
• Knowledge of emergency room coding, infusion coding, and/or specialty clinic procedure coding (having expertise within multiple areas is a huge bonus!)   

• Thrive in a fast-paced atmosphere and be able to flex and adjust to the highest priorities. 
• Character Traits: Solution-Based, Highly Motivated, Achiever, Positive, Genuine, Driven, Self-Discipline, Knowledge-Seeking, Responsible.  

Position Summary: 

The Hospital Outpatient Coder will be primarily responsible for hospital OP coding including ER (and associated professional fees), lab, radiology, and infusion.   They will ensure the timely and accurate coding of medical claims.  Furthermore, they will ensure maximum reimbursement for services provided by utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.  

Job Duties:

Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation.  Specific job duties will vary based upon client assignment.  Employee will also abide by ruralMED’s policies as a condition of employment.

Charge Entry

• Receive and review charge entry data from practice sites.
• Identify and investigate incomplete or missing charges.

Coding:

• Abstracts clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems.
• Sequences codes according to established guidelines.
• Thoroughly analyzes and interprets medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement.

Other:

• Maintains current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers.
• Maintains proficient knowledge of EHR, as well as any other systems, required for performing required job duties.
• Communicates issues to management, including payer, system, or escalated account issues. Identifies medical necessity denial trends and provide suggestions for resolution.
• May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution.
• Participates in department meetings, in-service programs, and continuing education programs.
• Maintains a professional attitude with patients, visitors, physicians, office staff and hospital personnel. Assures confidentiality of patient information, maintaining compliance with policies and procedures.
• Performs other duties as assigned.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to use hands and arms; talk and hear.  The employee frequently is required to sit, stand and walk.  The employee is occasionally required to reach with hands and arms, stoop, kneel, crouch or crawl, climb or balance and smell. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 40 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

This job operates in a professional office environment.  This role routinely used standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. While performing the duties of this job, the employee is usually in an air and temperature-controlled environment.  The noise level in the work environment is usually mild to moderate.

Minimum Qualifications:

• High School Diploma is required, Associates is preferred.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.
• Three to five years in emergency room coding, infusion coding or specialty clinic procedure coding.
• Knowledge of medical terminology is required.
• Proficient with Microsoft Office