Job Description: Oregon Health & Science University
Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.
Day Patient Surgery Coder (Facility) Trainer - Auditor (Coding Specialist lll)
US-OR-Portland
Job ID: 2024-30409 Type: Regular Full-Time # of Openings: 1 Category: Hospital/Clinic Support Portland, OR (Downtown)
Overview
Department support:
Serve as a resource to ERC daypatient coding leadership and coding team for a broad range of audit reviews, training and coder education.
Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, mentor and orientate coding staff as necessary.
Monitor coding and billing information from CMS guidelines, Professional licensing organizations, Internal communication memos, and transmittals from coding publishers and governmental agencies to advise facility and team of coding practice changes in CPT, ICD-10-CM, and HCPCS and ensure changes are implemented to maximize revenue and reflect medical evaluation of patient encounters.
Make recommendations to coding leadership and implement remedial actions for problems.
Attends coding meetings and seminars and shares knowledge with other coders. Participates in DP Huddles.
In collaboration with Enterprise Coding Leadership, develop and disseminate written procedures to facilitate and improve coding, biling and documentation processes.
Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, and stay informed of current coding practices for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
Coding
Coding at 95% or above accuracy
Facility:
Daypatient Coding
Observation services
Professional:
Complex Surgical coding
Integrated Desks (coding both facility and profee services for the same specialty)
Abstract information from patient medical records to assign correct codes to daypatient records and/or observation cases.Work assigned charge sessions in assigned EPIC charge router work queues.
Query physicians regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the health record when needed.
Assign correct CPT, ICD-10-CM; HCPCS; or ICD-10-PCS and DRGs for facility and/or professional charges, which would involve complex procedure and diagnostic coding within highly specialized coding areas.
Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
Coordinate patient encounter coding information and ensure that all information is complete and accurate before submission. Enter coding and billing information into EPIC, establish and maintain procedures and other controls necessary in carrying out all coding and billing activity.
Resolve coding denial requests or questions as part of a coding denial process. Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS).
Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU.
Coordinate all billing information and ensure that all information is complete and accurate.
Ability to maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orientate, and mentor coding staff as necessary.
Responsibilities
High school diploma or GED
Minimum of 4 years professional or hospital (depending on position) experience reviewing, abstracting, coding in ICD 10 CM or ICD 10 PCS, or CPT
Certification in one of the following (as indicated by the position description)
Coding certification from AAPC or AHIMA:
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA).
Active AHIMA membership may be required for some positions. Certified Professional Coder (CPC) through the American Academy of Professional Coders;
OR equivalent certification
Compliance with Code of Conduct, Respect in the workplace and Applicable policies, procedures and agreements related to position, department or OHSU as a whole
Must be able to perform the essential functions of the position with or without accommodation
Qualifications
Accredited Coding Program, Associates or Bachelor Degree; Specialized Coding Credential
Knowledge of OPPS guidelines and both CPT Inpatient and Outpatient coding guidelines. CCI edits and familiarity with medical necessity guidelines, NCD and LCD requirements.
Experience using an EMR.
Some college course work or education in classes related to anatomy/physiology, medical terminology, CPT and ICD-10-CM coding.
Knowledge of CPT Outpatient coding guidelines. CCI edits and familiarity with medical necessity guidelines.
Experience using EPIC, 3M encoder.
Advanced knowledge of CPT, ICD-10-CM, HCPCS, Federal Register, Federal and State insurance billing laws and Mandates.
Proficiency with word processing and Excel spreadsheets.
Excellent verbal and written communication skills with the ability to effectively communicate with individuals at all levels, physicians, nurses, administrative management, etc.
Ability to work as a team player.
Member of the American Academy of Professional Coders and Certified Professional Coder or AHIMA certification required upon hire.
Must be able to pass internal coding test to qualify as a Level 3.
