Assigns diagnosis and procedure codes for outpatient surgical or specialty encounters in the hospital or physician office setting. Abstracts required data elements for billing, reimbursement, and state reporting. Queries providers regarding incomplete or inconsistent documentation, resolves claim edits or denials related to coding, and ensures collected data is accurate, complete, and compliant with state and federal regulations as well as Official Guidelines for Coding and Reporting.
Accurately assigns ICD-10 diagnosis and CPT procedure codes for outpatient specialty services in the hospital or office setting.
Abstracts data elements based on defined standards and regulatory requirements.
Recognizes incomplete or missing documentation necessary to support code assignment and escalates appropriately to ensure timely resolution.
Ensures assigned codes reflect the highest degree of specificity supported by provider documentation.
Demonstrates understanding of standard coding and billing edits, as well as local and national coverage determinations.
Supports timely resolution of billing edits and claim denials based on functional expertise.
Appropriately communicates problems or issues related to timely completion of claims.
Completes coding-related duties as assigned to support Coding Operations and compliance with Service Level Agreements.
Meets or exceeds established productivity and quality standards.
Maintains required credentials and memberships.
HS diploma or equivalent education/experience.
CCS certification upon hire.
ROCC certification (Radiation Oncology Certified Coder).
1 year of recent relevant experience.
Knowledge of medical terminology, disease processes, patient health record content, and the medical record coding process.
Knowledge of computer-based encoder systems and accurate data entry skills.
Basic knowledge of anatomy, physiology, and pharmacology.
Familiarity with billing functions and the components of a charge description master.
General knowledge of revenue cycle applications, including electronic health record systems.
Familiarity with coding functions in acute and non-acute settings.
Knowledge of patient management information system applications.
Strong verbal and written communication skills.
Ability to use spreadsheet, word processing, statistical, project management, and presentation software, preferably Microsoft Suite.
Comprehensive benefits package.
Eligible positions include employer-provided benefits.
Regular full-time schedule with 40 hours per week.
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago