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CODER I – OUTPATIENT demonstrates proficiency in coding one outpatient service type to support Revenue Cycle Goals for timely billing. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Addresses NCCI, OCE, LCD and other coding edits as applicable.
Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, and complications. |
Accurately sequences diagnoses & procedures, maintains 95% accuracy. Assigns ICD-10 and CPT Codes. |
Performs charge reconciliation to ensure all submitted charges are posted accurately to ensure proper compliance and proper reimbursement. |
Demonstrates a consistent level of performance; strives to maintain a steady level of productivity. |
Appropriately holds accounts when more information is required for accurate code assignment. Contacts appropriate staff (CDI/Leadership/Medical Staff) as needed. |
Regularly reviews coding literature, keeps current on new or revised coding guidelines, shares information with colleagues, determined by colleagues’ feedback and supervisor observation |
Completes all assignments as directed by management in a conscientious and reliable manner. |
Expresses interest in and pursues continuing education both inside and outside the hospital. |
Works as a team member to meet department goals. |
Performs all related duties or special projects as assigned/required. |
Experience | Required | Preferred | Special Considerations |
| Experience | Required | Preferred | Special Considerations |
0-2 years | ☒ | ☐ | ☐ |
| 6-10 years | ☐ | ☐ | ☐ |
3-5 years | ☐ | ☐ | ☐ |
| 10+ years | ☐ | ☐ | ☐ |
Special Considerations Explained (if needed): |
| |||||||
Education | Required | Preferred |
|
High School / GED | ☒ | ☐ |
|
Vocational / Technical School | ☐ | ☒ |
|
Associate’s Degree | ☐ | ☐ |
|
Field of Study (Please Note) | Health Information Management / Coding / Billing | ||
Special Considerations Explained (if needed): | New graduate | ||
Licensure, Certification, and Registration | Required | Preferred | Special Considerations | |
Credential in good standing with AHIMA or AAPC | ☒ | ☐ | ☒ | |
| ☐ | ☐ | ☐ | |
| ☐ | ☐ | ☐ | |
Special Considerations Explained (if needed): | New graduate, candidate close to graduation, candidate eligible for certification. Those employed prior to 01/01/2021 were required to have an RHIA, RHIT, CCS, or other appropriate certification. Those hired after are required to have an RHIA, RHIT, CCS, CCA, CPC, CIC, COC, CPC, or any specialty credential accredited by AHIMA or AAPC within one year of hire. | |||
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