CERTIFIED CODER I

Description: The Certified Coder I performs functions of coding diagnosis and procedures from outpatient center/clinic records utilizing International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes. (Potential Remote)

Typical Duties:

• Assigns codes to diagnosis and procedures of outpatient records, including clinics, Urgent Care and Emergency room, utilizing ICD and CPT codes in accordance with ICD Coding Guidelines, CPT Coding Guidelines, American Hospital Association (AHA) Coding Clinics and the JPS Outpatient Coding Policy and Procedures. These charts are typically less than one day stays and are of low to medium clinical complexity of service requiring knowledge of anatomy, physiology and basic pharmacology.
• Ensures codes are assigned accurately and sequenced correctly ensuring reimbursement is appropriate in accordance with government, insurance, and/or other payer regulations to include the coding of diagnoses and procedures and may include the coding of signs and symptoms if needed to support medical necessity.
• Identifies, researches, and corrects or routes accounts on the coding and billing edit work queues to meet coding guidelines and facilitate accurate billing.
• Queries the provider when documentation is determined to be insufficient, conflicting or ambiguous to elicit documentation reflecting the most accurate and specific conditions or procedures.
• Maintains productivity and quality standards set forth in the District's outpatient coding standards.
• Utilizes online and hard copy coding reference materials.
• Works closely with Outpatient Coding Supervisor and the health center/clinic medical and nursing staff regarding documentation and notification of charging issues.
• Demonstrates evidence of professional growth by attending coding workshops, conferences and or seminars, maintaining required C.E. requirements (departmental and professional), and individual study and education regarding coding, reimbursement, and HIM competencies.
• Performs other job related duties as assigned.