Title: Outpatient Medical Coder

Department: HIM - Medical Records

Reports to: Manager - Coding and Data Quality

Job Code/Cost Center: 10000-50072-003058

FLSA Status: Non – Exempt

Position Objective:

**This position is PRN**

The Outpatient Medical Coder under the supervision of the Manager of Coding and Data Quality codes hospital Emergency Department and ancillary visit records for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10 diagnostic coding and CPT-4 procedure coding classification systems. 

Essential Job Duties:

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Identifies and assigns ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient visits including ED, clinic, recurring rehabilitation, recurring psychiatry and other recurring visit locations for the purpose of reimbursement, research and compliance with federal and state regulations.
2. Monitors assigned work on a daily basis in order to facilitate the billing process within the established timeframes. Codes and abstracts records within timeframes established for each patient type.
3. Review medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignment.
4. Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignment.
5. Maintain a high level of accuracy in code assignment to prevent claim denials, billing errors, and potential legal issues.
6. Communicates with various departments within the hospitals regarding billing and registration issues. Refers any problems to management timely, providing clear details.
7. Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA (Health Insurance Portability and Accountability Act) privacy regulations.
8. Participate in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials.
9. Demonstrates support and compliance with Luminis Health Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.

Educational/Experience Requirements:

Required Minimum Education. The minimum level of education for this position includes:

High School graduate or equivalent. Formal ICD-10-CM and CPT training required. Associate or bachelor’s degree preferred.

Required License/Certifications:

Certification as a Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA) required. Preferred Registered Health Information Technician (RHIT), Registered Health information Administrator (RHIA).

Knowledge, Skills, Abilities:

Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.

Working Conditions, Equipment, Physical Demands:

Light work. Exerting up to twenty pounds of force occasionally, and/or up to ten pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

There is reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.