HIM Coder I- ED Coding

General Summary

Collects, reviews, retrieves and codes data from electronic records and scanned physician orders on outpatient ancillary or emergency accounts, assigning the appropriate ICD-10-CM codes for the purposes of compliance with regulations, statistical compilation, and optimal reimbursement.

Duties and Responsibilities

Essential Functions:

• Reviews physician reports, radiology reports, physician orders and other documentation and assigns appropriate ICD-10 diagnoses codes following established organizational guidelines and to support medical necessity
• Follows Official Guidelines for Coding and Reporting using encoding software to identify coding edits and reviews Epic documentation to institute appropriate course of action.
• Works assigned Epic Account, Charge Review or Claim Edit work queues to identify and investigate Epic edits for coding errors, charge capture, or claim edits and reviews Epic documentation to institute appropriate course of action according with NCCI, LCD, OCE and CPT guidelines. Works with billing and ancillary departments to resolve billing edits and inquiries.
• Abstracts clinical data, including Attending Physician, Surgeon, Consultant, and discharge disposition for accurate reporting and claim submission.
• Performs other duties that may be assigned by authorized personnel or as required to meet emergency needs of the department or Hospital.

Common Expectations:

• Maintains job specific standards and expectations relative to productivity and quality.
• Maintains established policies and procedures, objectives, quality assessment and safety standards.
• Participates in educational programs and in-service meetings.
• Maintains professional growth and development and professional credentials.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.