Baylor Scott & White Health
Coder II - OP Physician Coding
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Job Summary The Coder II is proficient in three or more types of outpatient, professional fee, or low acuity inpatient coding. He/she may code low acuity inpatients, one‑time ancillary/series, emergency department, observation, day surgery, and/or professional fee including evaluation and management (E/M) coding or professional fee surgery. For professional fee coding, individuals in this job will be proficient for inpatient and outpatient for multiple specialties. The Coder II utilizes the International Classification of Disease (ICD‑10‑CM, ICD‑10‑PCS), Healthcare Common Procedure Coding System (HCPCS), including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS‑DRG, APR‑DRG, APC, etc.). The Coder II will abstract and enter required data.
Essential Functions of the Role
Analyzes and interprets documentation from medical records and completes accurate coding of diagnosis, procedures, and professional fees.
Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
Communicates with providers for missing documentation elements and offers guidance and education when needed.
Reconciles billing issues by determining the rationale for rejecting and correcting inaccurate charges.
Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.
Reviews and edits charges.
Key Success Factors
Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
Sound knowledge of anatomy, physiology, and medical terminology.
Demonstrated competency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
Sound knowledge of ICD‑10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
Flexibility and adaptability while balancing requirements and regulatory and accreditation guidelines that are non‑negotiables.
Must Have One of the Following Certifications
Registered Health Information Administrator (RHIA)
Registered Health Information Technologist (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist Physician‑based (CCS‑P)
Certified Professional Coder (CPC)
Certified Outpatient Coder (COC)
Certified Inpatient Coder (CIC)
Certified Interventional Radiology Cardiovascular Coder (CIRCC)
Benefits
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar‑for‑dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1
Qualifications
Education: High School Diploma / GED Equivalent
Experience: 2 years in a coder I or II position
Certification: Any of the certifications listed above
Seniority Level Entry level
Employment Type Full‑time
Job Function Engineering and Information Technology
Industry Hospitals and Health Care
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Job Summary The Coder II is proficient in three or more types of outpatient, professional fee, or low acuity inpatient coding. He/she may code low acuity inpatients, one‑time ancillary/series, emergency department, observation, day surgery, and/or professional fee including evaluation and management (E/M) coding or professional fee surgery. For professional fee coding, individuals in this job will be proficient for inpatient and outpatient for multiple specialties. The Coder II utilizes the International Classification of Disease (ICD‑10‑CM, ICD‑10‑PCS), Healthcare Common Procedure Coding System (HCPCS), including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS‑DRG, APR‑DRG, APC, etc.). The Coder II will abstract and enter required data.
Essential Functions of the Role
Analyzes and interprets documentation from medical records and completes accurate coding of diagnosis, procedures, and professional fees.
Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
Communicates with providers for missing documentation elements and offers guidance and education when needed.
Reconciles billing issues by determining the rationale for rejecting and correcting inaccurate charges.
Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.
Reviews and edits charges.
Key Success Factors
Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
Sound knowledge of anatomy, physiology, and medical terminology.
Demonstrated competency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
Sound knowledge of ICD‑10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
Flexibility and adaptability while balancing requirements and regulatory and accreditation guidelines that are non‑negotiables.
Must Have One of the Following Certifications
Registered Health Information Administrator (RHIA)
Registered Health Information Technologist (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist Physician‑based (CCS‑P)
Certified Professional Coder (CPC)
Certified Outpatient Coder (COC)
Certified Inpatient Coder (CIC)
Certified Interventional Radiology Cardiovascular Coder (CIRCC)
Benefits
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar‑for‑dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1
Qualifications
Education: High School Diploma / GED Equivalent
Experience: 2 years in a coder I or II position
Certification: Any of the certifications listed above
Seniority Level Entry level
Employment Type Full‑time
Job Function Engineering and Information Technology
Industry Hospitals and Health Care
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