Reviews and evaluates hospital outpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes. Performs coding and/or code validation across multiple entities. Applies all appropriate coding guidelines and criteria for code selections. Adheres to Company and HSC Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedures.
Duties (included but not limited to):
• Using, ICD-10-CM and/or HCPCS/CPT, primarily assigns, validates, and/or edits codes the following patient types:
o Same day surgery (SDC) o Observation (OBV)
o Wound Care
o Outpatient Cardiac Cath
• As needed, may also assign, validate, and/or edit codes for the following patient types:
o Emergency department (ED)
o Recurring (RCR)
o Clinical (CLI) records, and/or
o Provider Office Visit (POV)
• Assigns, validates, and/or edits procedure categories, modifiers (when applicable)
• Maintains or exceeds established productivity standards
• Maintains or exceeds established accuracy standards
• Initiates, validates, and/or edits physician queries in compliance with Company and HSC policy where appropriate
• As needed, may periodically be asked to perform Coding Account Resolution Specialist II and/or I (CARS II and I) duties
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
• Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes
• Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes
• Meets all educational requirements as stated in current Company and HSC policy
• Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned
High School graduate or GED equivalent required, undergraduate (associate or bachelors) degree in HIM/HIT preferred.
One (1) year acute care observation and/or same day surgery hospital outpatient coding experience required.
RHIT, RHIA or CCS preferred.
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom