Hospital Outpatient Coder

ruralMED Management Resources


The Hospital Outpatient Coder will perform hospital outpatient coding including: ER (and associated professional fees), surgical, lab, radiology and infusion specialties while working remotely. They will ensure the timely and accurate coding of medical claims and maximum reimbursement for services provided by utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.

Job Description:

ruralMED Management Resources Job Description
Title: Hospital Outpatient Coder
Facility: Remote/ ruralMED Revenue Cycle Resources
Reports To: Revenue Cycle Supervisor/Lead Medical Coder & Audit Specialist/CBO Site Manager
Supervises: NA
Status: PRN

Job Duties:

Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Specific job duties will vary based upon client assignment. Employee will also abide by ruralMED’s policies as a condition of employment.

Charge Entry
• Receive and review charge entry data from practice sites.
• Identify and investigate incomplete or missing charges.
• Abstracts clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems.
• Sequences codes according to established guidelines.
• Thoroughly analyzes and interprets medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement.
• Conducts training for physicians/staff on coding and or documentation practices.
• Maintains current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers.
• Maintains proficient knowledge of EHR, as well as any other systems, required for performing required job duties.
• Communicates issues to management, including payer, system, or escalated account issues. Identifies medical necessity denial trends and provide suggestions for resolution.
• May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution.
• Participates in department meetings, in-service programs, and continuing education programs.
• Maintains a professional attitude with patients, visitors, physicians, office staff and hospital personnel. Assures confidentiality of patient information, maintaining compliance with policies and procedures.
• Performs other duties as assigned.

Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands and arms; talk and hear. The employee frequently is required to sit, stand and walk. The employee is occasionally required to reach with hands and arms, stoop, kneel, crouch or crawl, climb or balance and smell. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 40 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Required Qualifications:

Minimum Qualifications:
• High School Diploma is required, Associates is preferred.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.
• Two to five years medical coding experience is required.
• Knowledge of medical terminology is required.
• Proficient with Microsoft Office

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