Outpatient Coding Specialist

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

📋 Description

• Review medical record documentation and accurately assign ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT IV, and HCPCS codes.

• Code outpatient visits, including ancillary, urgent care, emergency department, observation, same-day surgery, and interventional procedures.

• Abstract necessary data in accordance with facility specifications.

• Conduct medical necessity checks for Medicare and other payers.

• Collaborate as a team to monitor and address discharged-not-final-billed accounts, failed claims, stop bills, and epremis.

• Ensure the timely and compliant processing of outpatient claims.

• Meet productivity requirements, 3M 360 CAC KPIs, and quality standards.

• Stay updated on CMS requirements, NCD and LCD guidelines, and modifier assignment criteria.

• Utilize 3M encoder, CAC, medical necessity software, abstracting systems, coding books, and reference materials.

• Report any inaccuracies in coding software to HIM management/supervisor.

• Notify about potential unethical or fraudulent activities in accordance with compliance policy.

• Adhere to Mercy Health policies and procedures, including PTO requirements.

• Participate in required meetings and educational sessions, completing annual learning programs.

• Undertake training and mentoring SMART responsibilities where applicable.

⛳️ Requirements

• Must possess Outpatient Surgery Coding Experience.

• Hold a Vocational/Technical Degree in HIM / Coding Certification.

• Completion of a Coding Curriculum along with one year of prior coding experience.

• Maintain active, non-expired licensure/certification requirements as applicable.

• If RHIA, RHIT, or CCA is obtained upon hire without COC or CCS, must secure COC or CCS and CRCR within one year of hire.

• Successfully complete Medical Terminology and Anatomy and Physiology coursework.

• Complete ICD-10 training.

• Previous experience utilizing coding software tools.

• Knowledge of medical record content, including electronic medical records (EMRs).

• Capability to function independently with minimal supervision as well as collaboratively within a team.

• Ability to operate effectively under continual deadlines.

• Maintain accuracy during frequent interruptions.

• Proficiency in keyboarding and possess a working knowledge of computers.

• Exhibit excellent communication skills.

• Preferred: prior coding experience in an acute care setting and familiarity with CAC.

🏝️ Benefits

• Competitive pay.

• Incentives.

• Referral bonuses.

• 403(b) with employer contributions (when eligible).

• Medical, dental, vision, and prescription coverage.

• HSA/FSA options.

• Life insurance.

• Mental health resources and discounts.

• Paid time off.

• Parental and FMLA leave.

• Short- and long-term disability.

• Backup care for children and elders.

• Tuition assistance.

• Professional development opportunities.

• Support for continuing education.

• Work-from-home arrangement.