Ambulatory Practice Coder II in Middlebury, Connecticut at Waterbury Hospital

POSITION SUMMARY:

Under the general supervision of the Revenue Cycle Manager and according to established procedures, accountable for assignment of diagnoses and procedures for surgical services and ambulatory practices. Interprets clinical and diagnostic documentation and assigns appropriate ICD-10 (current edition) and / or CPT codes as well as modifiers, and other charges as appropriate adhering to official coding guidelines. Requires knowledge of surgical coding, ambulatory classifications and coding guidelines. Ensure records are coded in an accurate and timely manner.

EDUCATION/CERTIFICATION

• High School Diploma or equivalent required.
• CPC, CCS, or CCS-P credential required
• Must maintain active coding credential by obtaining qualifying CEUs as needed.

EXPERIENCE

• Minimum four (4) years of surgical and ambulatory coding experience or related work experience required.

COMPETENCIES

• Thorough knowledge of ICD CM (current edition and CPT coding as well as CCI edits.
• Thorough knowledge of third party payer requirements as well as federal and state guidelines and regulations pertaining to coding and billing practices.
• Self-starter and have the ability to work in a deadline driven environment.
• Experience with Allscripts and/or Athena systems preferred
• Experience with RCxRules a plus
• Strong knowledge of medical terminology, anatomy, and physiology.
• Experience with Microsoft applications.
• Excellent verbal and written communication skills using the English language along with good interpersonal skills are necessary.

ESSENTIAL DUTIES and RESPONSIBILITES:

Disclaimer: Job descriptions are not intended, nor should they be construed to be, exhaustive lists of all responsibilities, skills, efforts or working conditions associated with the job. They are intended to be accurate reflections of the principal duties and responsibilities of this position. These responsibilities and competencies listed below may change from time to time.

Job-Specific Competency

1. Upon review of the medical record, performs analysis on documentation, which includes review of tests / reports to determine the appropriate ICD-10 (current edition) and / or CPT codes as well as modifiers and other procedure codes as defined by official coding guidelines and other recognized reference materials.
2. Uses documentation to substantiate codes assigned.
3. Assists in resolving incomplete and/or missing documentation in order to expedite final coding and billing.
4. Attends required training classes and coding in-services each year to stay knowledgeable of new regulations and coding guidelines. Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.
5. Adheres to the coding and billing regulations established by the American Hospital Association (AHA), American Medical Association (AMA), and Centers for Medicare and Medicaid Services (CMS).
6. Performs job requirements in adherence to MPP Coding policies and procedures. Complies with all organizational policies regarding ethical business practices.
7. Utilizes available references as needed
8. Willing to accept additional assignments.