Lead Coding Specialist - Outpatient Telecommute

Summary:

Under the general supervision of the Director of Ambulatory Coding Services the lead outpatient coder reviews medical record documentation and all clinical documentation to extract data and assign appropriate codes in accordance with the outpatient guidelines for professional and facility coding guidelines. Knowledge ofICD-10 CM/PCS and CPT Official Guidelines for Coding and Reporting of outpatient scenarios covering complex disciplinary service lines throughout all Brown University Health affiliates. Determines appropriate code assignment for optimal classification and accurate and compliant clinical reporting.

Responsibilities:

Reviews outpatient medical records covering complex disciplinary service lines to accurately identify all treated diagnoses and procedures performed reporting the correct ICD-10 CM/PCS code(s) in accordance with official coding guidelines. Ensures the medical record documentation supports the codes selected for the principal diagnosis secondary diagnoses complications co-morbid conditions procedures and discharge disposition.

Understands clinical documentation to recognize when a query to the physician is required. Identifies and recommends physician queries when documentation in chart is incomplete ambiguousor unclear. Maintains coding accuracy and productivity standards. Acts as a resource to coding staff on official coding principals and guidelines.

Works collaboratively with denial management teams to correct coding related denials including medical necessity and modifier usage. Research payor policy and guidelines as it relates to coding and billing scenarios for the outpatient setting.

Perform peer-to peer training and answer routine daily questions.

Critical thinking and problem solving consisting of identifying and resolving problems in a timely manner and/or developing alternative solutions.

Serves as preceptor and mentor with new staff providing oversight and resources when needed.

Ability to recognize and understand clinical documentation pertinent for coding.

Good written communication skills to prepare compliant physician queries.

Actively participates in team meetings to enhance functional excellence. Abides by the *Standards of Ethical Coding* as set forth by the American Health Information Management Association.

Other information:

EDUCATION:

Associate degree in health information technology or equivalent experience; Coding Certification required from coding certification program AAPC or AHIMA. Maintaining Coding Professional Credentials/competencies through internal and external educational opportunities.

EXPERIENCE:

Minimum 3 years of experience outpatient coding. Working knowledge of EMR system ICD-10 CM/PCS CPT and HCPCS guidelines.

WORKING CONDITIONS:

Requires long periods of sitting to review medical records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy.

INDEPENDENT ACTION:

Performs independently within the department*s policies and practices. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required.

SUPERVISORY RESPONSIBILITY:

None

Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: Brown University Health Corporate Services USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union