Primary Responsibilities:

• Identify appropriate assignment of CPT and ICD-10 Codes for outpatient surgery, observation, CVIR, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts
• Understand the Medicare Ambulatory Payment Classification (APC) codes
• Abstract additional data elements during the chart review process when coding, as needed
• Adhere to the ethical standards of coding as established by AAPC and/or AHIMA
• Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360
• Provide documentation feedback to providers, as needed, and query physicians when appropriate
• Maintain up-to-date coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, among others
• Participate in coding department meetings and educational events
• Review and maintain a record of charts coded, held, and / or missing
• Additional responsibilities as identified by manager

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma/GED (or higher)
• Professional coder certification with credentialing from AHIMA and/or AAPC (ROCC, CPC, COC, CPC-P, CCS) to be maintained annually
• 2+ years of Outpatient Facility coding experience
• Experience with ICD-10
• Experience with LCD, NCD, Medical Necessity, Modifier Edits
• Ability to use a PC in a Windows environment, including Microsoft Excel and EMR systems
• Ability to work flexible hours; will have the opportunity to choose between Monday – Friday (1 weekend day is required) – 40 hours/week, including the flexibility to work occasional overtime per business need

Preferred Qualifications:

• Experience with complex cardiac catheterizations and interventional radiology (CVIR/IVR)
• Experience with various encoder systems (eCAC,3M, EPIC)
• Intermediate level of experience with Microsoft Excel
• Experience with OSHPD reporting