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Role Description

The Hospital Outpatient Coder with ruralMED will be primarily responsible for hospital OP coding including ER (and associated professional fees), surgical, lab, radiology and infusion. They will ensure the timely and accurate coding of medical claims and maximize reimbursement for services provided by utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.

• Charge Entry
  • Receive and review charge entry data from practice sites.
  • Identify and investigate incomplete or missing charges.
• Coding
  • 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.
• Other
  • 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 provides 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.

Qualifications

• Knowledge of medical terminology is required.
• Proficient with Microsoft Office.

Requirements

• High School Diploma is required, Associates Degree is preferred.
• Two to five years medical coding experience is required.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.
• 100% Remote.