Department of Medicine Coder (Coding Specialist ll) in Portland, Oregon at Portland, OR (Downtown)

Job Function: General BusinessEmployment Type: Full-Time
Portland, OR (Downtown)
Portland, Oregon, 97222, United States
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Job Description

Overview

Coding:

  • Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS).
  • Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry.
  • Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU.
  • Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
  • Coordinate all billing information and ensure that all information is complete and accurate.
  • Ability to maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
  • Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orientate, and mentor coding staff as necessary.

Department support:

  • Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
  • Attends coding meetings and seminars and shares knowledge with other coders. Participates in EC Huddles.
  • In collaboration with Enterprise Coding Leadership, develop and disseminate written procedures to facilitate and improve billing and documentation processes.
  • In collaboration with Leadership, make recommendations and implement remedial actions for problems
  • Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in CPT, ICD-10-CM,and HCPCS
  • Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, stay informed of current trends in coding.

Perform other duties as assigned.



Responsibilities

  • High School diploma or GED.
  • Minimum two years of hospital or professional services (dependent on position) experience reviewing, abstracting, and coding medical records using ICD-10-CM and CPT coding;
  • Coding certification from AAPC or AHIMA:
    • Registered Health Information Administrator (RHIA),
    • Registered Health Information Technician (RHIT),
    • Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA).
    • Active AHIMA membership may be required for some positions.
    • Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR equivalent certification.
  • Qualifications

    • Accredited Coding Program required: AAPC Boot Camp, AHIMA Coding Boot Camp
    • Knowledge of OPPS guidelines and both CPT Inpatient and Outpatient coding guidelines. CCI edits and familiarity with medical necessity guidelines, NCD and LCD requirements.
    • Experience using an EMR.
    • Some college course work or education in classes related to anatomy/physiology, medical terminology, CPT and ICD-10-CM coding.
    • Experience using EPIC, 3M encoder
    • Knowledge of CPT, ICD-10-CM, HCPCS, Federal Register, Federal and State insurance billing laws and Mandates.
    • Proficiency with word processing and Excel spreadsheets.
    • Excellent verbal and written communication skills with the ability to effectively communicate with individuals at all levels, physicians, nurses, administrative management, etc.
    • Ability to work as a team player.
    • Member of the American Academy of Professional Coders and Certified Professional Coder or AHIMA certification required upon hire.
    • Must be able to pass internal coding test.

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    Job Location

    Portland, Oregon, 97222, United States

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