Hoag Health center.

  • Costa Mesa, CA


  • Irreversible.

  • Full-time.

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Coder II – Medical Coding

Department: Organization Solutions

Status: Full Time

Shift: 1st

Reviews scientific documentation and diagnostic outcomes as proper to draw out data and apply appropriate ICD-10- CM, ICD-10- PCS and/or CPT-4 codes for billing, internal and external reporting, research and regulatory compliance activities. Fix mistake reports related to the billing procedures, identify and report mistake patterns and when essential assist in the design and execution of work flow changes to minimize billing errors. Should satisfy continuous efficiency and quality metrics as established within the department for each level. Coder may work remote if minimum innovation requirements, performance and quality requirements are fulfilled and they sign, and follow, the Telecommuter Work Agreement.

Vital Functions

Level I:

  • Identifies chargeable products and facility level for emergency department sees, including observation services, and enters them into billing system.
  • Meet and/or go beyond the recognized quality standard of 95% precision rate or much better while meeting and/or surpassing recognized production standards.
  • – OR-
  • Uses technical coding principles and APC repayment competence to appoint appropriate ICD-10- CM and CPT-4 procedures.
  • Appoints codes for medical diagnoses and treatment according to the suitable classification system for secondary outpatient encounters, consisting of modifier task.
  • Meet and/or exceed the established quality requirement of 95% accuracy rate or much better while meeting and/or going beyond recognized production standards.

Level II:

  • Evaluation SANCTUARY for documents inconsistencies and precision
  • Plan of treatment review for an accurate reflection of client’s condition and medical diagnosis
  • Conduct reviews of house health and hospice coding and offer suggestions for suitable coding based upon present coding guidelines
  • Offer composed feedback to field staff related to paperwork and coding
  • Maintain proficiency/knowledge of SANCTUARY Data set items, house care reimbursement, and compliance as related to OASIS policies and requirements
  • Maintain proficiency/knowledge of coding standards
  • Maintain Coding Certification
  • Establish and maintain knowledge of software application systems used by the house health and hospice company
  • Utilizes technical coding principles and APC repayment proficiency to appoint suitable ICD-10- CM and CPT-4 procedures.
  • Designates codes for medical diagnoses, treatment and procedures according to the suitable classification system for Outpatient Procedures and Emergency Department comes across, including modifier project.
  • Determines chargeable items and center level for emergency department sees, consisting of observation services, and enters them into billing system.
  • Meet and/or go beyond the established quality requirement of 95% accuracy rate or better while conference and/or exceeding established production standards

Education, Training and Experience

Level I

Required:

  • High school diploma or equivalent.
  • 2 years of health center severe care OP diagnostic coding experience or graduation from a CAHIM recognized HIT program and is CCS eligible or RHIT eligible.

Preferred:

  • Effective completion of a licensed coding program. Credentials to consist of one or a combination of the following: CCA, CCS, CCS-P, RHIT and/or RHIA. CPC and/or CPC-H will be thought about with appropriate outpatient coding experience.

Level II

Required:

  • Two years of progressive hospital severe care coding experience including ER, outpatient treatment and same day surgical treatment.
  • Successful completion of a licensed coding program. Credentials to consist of one or a combination of the following: CCA, CCS, CCS-P, RHIT and/or RHIA. CPC and/or CPC-H maybe considered with relevant outpatient coding experience

Abilities or Other Credentials

Needed:

  • Capability to code and preserve corporate/department specific quality standards and meet efficiency requirements as documented by the department and company.
  • Understanding of medical terminology, anatomy and physiology, disease procedure and small surgical procedures.
  • Knowledge of accepted medical abbreviations and their significances.
  • Knowledge in making use of specialized referrals such as the ICD-9-CM and CPT-4 books, medical dictionaries and texts, and medical journals.
  • Needs to have substantial understanding of Coding Clinic, CPT Assistant, and all main coding guidelines.
  • Advanced knowledge of hospital info systems, encoders and other technology to facilitate an effective virtual work environment while preserving optimum communication and adhering to HIPAA security requirements.
  • Advanced understanding of MS Excel, Word and Outlook functions.
  • Abides by the standards of Ethical Coding as set forth by the American Health info Management Association (AHIMA) and sticks to all official coding guidelines.
  • Technical skills needed to discover and browse a range of software systems, trouble-shoot computer system issues, install routine updates to software programs and work effectively in a virtual environment.
  • Strong written and spoken communication skills.
  • Capability to think/work individually, yet engage positively with a remote team.
  • Advanced problem-solving abilities.
  • Familiarity with present healthcare based technology, coding, and Electronic Health Record (HER).
  • Attention to detail is crucial to this position.

Preferred:

  • Well-informed in Income Cycle department works connecting to Ambulatory Payment Classification (APC) grouping, rejections and edits.

Nearby Significant Market: Orange County

Nearby Secondary Market: Los Angeles.

Hoag Healthcare facility.

  • View & Apply.