Ambulatory Surgery & Observation Outpatient Coder REMOTE
Saint Joseph Mercy Health System

Job Info

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Employment Type:
Full time
Shift:

Description:
Analyzes physician/provider documentation contained in assigned Emergency Department (ED) and/or Outpatient Observation/Ambulatory Surgery health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of Internal Classification of Diseases, Clinical Modification diagnosis and procedure codes, and Current Procedural Terminology / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers.

Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA) Coding Clinic, American Medical Association (AMA) for CPT codes and CPT Assistant, American Health Information Management Association (AHIMA) Standards of Ethical Coding, Revenue Excellence/Regional Health Ministry (RHM) coding policies and Trinity Health Coding Manual (TBA).

ESSENTIAL FUNCTIONS

Proficiently navigates the patient health record and other computer systems/sources in determination of diagnoses procedures and modifiers to be coded and/or for APC assignment. Codes Emergency Department and/or Outpatient Observation/Ambulatory Surgery utilizing encoder software and online tools and references, in the assignment of ICD-, CPT, and HCPCS codes and modifiers.

Validates and/or revises charges by comparing charges with health record documentation as necessary.

Formulates compliant clarifications/queries following Trinity Health's documentation integrity procedures.

Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record.

Communicates effectively with clinical staff, physicians and office staff regarding documentation issues or needs.

Communicates with case management concerning Outpatient Observation documentation issues.

Collaborates with Patient Financial Services in resolving billing and utilization issues affecting reimbursement.

Identifies concerns and notifies appropriate leadership for resolution. Provides routine problem resolution as needed.

Tracks issues (i.e., missing documentation or charges) that require follow-up to facilitate coding in a timely fashion.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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