Coder I Outpatient

**Primary City/State:** Virtual - Arizona **Category:** Health Information **Shift:** Day **Department:** Coding Outpatient Coder I **Great care starts with great people. (Like you.)** At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area. **Responsibilities:** JOB SUMMARY Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT and HCPCS codes through review of inpatient or outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. ESSENTIAL FUNCTIONS * Inpatient: • Assigns and sequences ICD-10-CM and ICD-10-PCS diagnostic and procedural codes for inpatient accounts within HonorHealth. • Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. • Utilizes electronic medical record and computer-assisted coding (CAC) software. • Addresses applicable coding edits. • Assigns DRGs as applicable. * Outpatient: • Assigns and sequences ICD-10-CM, CPT and HCPCs diagnostic and procedural codes for outpatient accounts within HonorHealth. • Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. • Utilizes electronic medical record and computer-assisted coding (CAC) software. • Addresses NCCI, OCE, LCD, and other applicable coding edits. * Inpatient: • Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. • Reviews and analyzes medical records for accurate ICD code selection. * Outpatient: • Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. • Reviews and analyzes medical records for accurate ICD and CPT code selection. * Inpatient/Outpatient: • Communicates and assists in education with an audience that may include physicians and clinical staff. * Inpatient: • Assists Patient Financial Services with interpretation and selection of appropriate ICD codes and /or other information requested for accurate billing and reimbursement. • Possesses knowledge and understanding of failed bill parameters. * Outpatient: • Assists Patient Financial Services with interpretation and selection of appropriate ICD, CPT, and HCPCs codes and /or other information requested for accurate billing and reimbursement. • Possesses knowledge and understanding of failed bill parameters. * Inpatient/Outpatient: • Performs outpatient charge validation/reconciliation for outpatient coding to ensure all submitted charges are posted timely and balance with total submitted charges. • Assigns charges as applicable. * Inpatient/Outpatient: • Resolves routine coding issues/problems and appropriately seeks assistance from supervisor. * Performs other duties as assigned. EDUCATION * High School Diploma or GED **Required** * Associates in health related field Preferred EXPERIENCE * Other Inpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM and ICD-10-PCS codes. **Required** or * Other Outpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM, CPT, and HCPCs codes. **Required** * 2 years Inpatient: Hospital inpatient coding. Preferred or * 2 years Outpatient: Coding outpatient accounts which may include Emergency department, newborn, obstetrics, day surgery, observation, wound care, radiology, laboratory, series, infusion, oncology, and rehab therapy. Preferred * Other Inpatient: Knowledge of pathology, pharmacology, microbiology, radiology, and other clinical specialties. Preferred or * Other Outpatient: Working knowledge of charging and billing processes. Working knowledge of Medicare, NCCI, OCE, LCD, NCD, and other claim edit guidelines and protocol. Preferred LICENSE AND CERTIFICATIONS * CCA (Certified Coding Apprentice) with successful certification of CCS in 6 months **Required** or * Inpatient: CCS (Certified Coding Specialist), or CIC (Certified Inpatient Coder), or RHIT () or RHIA (Registered Health Information Administrator) **Required** * Outpatient: CPC-H (Certified Professional Coder-Hospital Outpatient), or CPC (Certified Professional Coder), or COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist), or RHIT () or RHIA (Registered Health Information Administrator) **Required** * CPC-H/COC, CIC, RHIT, or RHIA Preferred We're all in for your career.