Medical Coder, Outpatient

This is a fully remote position, open to applicants in United States.

📋 Description

• Responsible for coding outpatient encounters, which include clinic visits, urgent care, radiology, lab services, ancillary services, and outpatient surgeries.

• Utilize ICD-10-CM, CPT-4, and HCPCS Level II coding systems.

• Assign E/M levels in accordance with current E/M guidelines, CPT Assistant, and Coding Clinic standards.

• Implement NCCI bundling edits and apply the appropriate modifiers such as 25, 59, and 91.

• Assess whether multiple CPT codes are components of a larger procedure.

• Allocate ICD-10 diagnoses to ancillary or diagnostic tests based on medical necessity criteria.

• Review documentation within CPRS and input codes and data into the VistA Patient Care Encounter (PCE) package using the VA-approved encoder.

• Determine the billable status of encounters.

• Identify duplicate encounters, those created in error, and records lacking support for assigned codes.

• Re-evaluate coded records upon request from the VA prior to billing or following claim denials.

• Maintain a coding accuracy rate of at least 95% and adhere to each facility's turnaround times.

• Provide support to Veterans Affairs medical centers in VISN 7, covering Georgia, Alabama, and South Carolina.

⛳️ Requirements

• Must possess an active CPC, CCS, CCS-P, RHIT, RHIA, or CPC-H credential.

• A minimum of 2 years of recent experience in outpatient coding, including E/M, ancillary services, and outpatient procedures.

• Completion of an accredited coding, health information management (HIM), or health information technician program.

• Formal training in anatomy and physiology, medical terminology, pathophysiology, pharmacology, and reimbursement methodologies.

• Comprehensive understanding of CPT, HCPCS, NCCI edits, and modifiers.

• Proficient in the use of an industry-standard encoder.

• Must be a US citizen.

• Capability to pass a federal background investigation (NACI) and undergo fingerprinting.

• Must have a private, secure home workspace equipped with reliable high-speed internet.

• Required to complete VA annual Privacy and Information Security Awareness and HIPAA training (TMS 10176 and 10203) before commencing work and annually thereafter.

• Adhere to AHIMA's Standards of Ethical Coding and VA confidentiality policies.

• Must not apply "incident to" billing regulations.

• Preferred qualifications include experience with VA systems like VistA, CPRS, PCE, and Integrated Billing.

• Preferred: background in coding outpatient surgery or ambulatory surgery.

• Preferred: experience in coding radiology or lab for a hospital setting.

🏝️ Benefits

• Enjoy the flexibility of 100% remote work.

• A laptop will be provided.

• An encoder will be supplied for coding tasks.

• Reference materials will be made available.

• Annual VA Privacy and Information Security Awareness and HIPAA training will be provided.

• Commitment to equal opportunity employment.

• We highly encourage applications from Veterans, Reserve and National Guard members, as well as transitioning active-duty service members.