Responsible for the accurate and timely review, analysis, and assignment of ICD-10-CM, CPT, and HCPCS codes for outpatient and clinic services in accordance with official coding guidelines, payer requirements, and Boys Town policies.
MAJOR RESPONSIBILITIES & DUTIES:
Reads and interprets medical record documentation to include diagnostic and procedural phrases performed during the visit (e.g., observation, inpatient, surgery, clinic encounter, etc.) and then translates them into appropriate coding form.
Analyzes health record to identify relevant diagnoses, procedures, supplies, and modifier requirements for distinct patient encounters for a variety of specialties.
Applies knowledge of ICD-10-CM, CPT, and HCPC coding guidelines and notes to accept and assign the correct diagnosis, procedural, or supply/ service codes, as documented, and sequences them correctly within the encounter.
Clarifies conflicting or ambiguous information appearing in the medical record by consulting the appropriate physician or clinician to ensure sufficient documentation and accurate code selection.
Utilizes internal and external resource and reference systems such as Encoder and AAPC news bulletins to ensure accuracy and current coding selections are utilized.
Prioritizes caseload based on date of receipt and charge source (e.g., paper encounter, operative note, reference lab invoice, or electronic medical record. Charges worked via the EMR shall be worked according to modified date ready to ensure timely filing requirements are adhered to.
Reviews individual encounter level system-generated claim edits to correct or complete missing data elements.
Conduct focused coding/encounter audits across multi-specialty practices to include providing brief yet detailed accounts of findings as well as suggested action plans for corrected claims and provider/staff education to the Coding Leadership.
Resolves coding and reimbursement issues with Patient Financial Services staff and third-party payers and assists in implementing solutions to reduce back-end billing errors, while maximizing revenue and reimbursement opportunities.
Provides back-up to the Hospital Coding team as needed to meet all coding group KPI’s and metrics.
Abides by the Standards of Ethical Coding as set forth by the American Information Management Association (AHIMA) and adheres to official coding guidelines and organizational compliance.
Other Duties: This job description incorporates the essential functions and duties required for this position. However, other duties may be required and assigned at times and as determined by a supervisor in order to meet the needs of the organization.
KNOWLEDGE, SKILLS, AND ABILITIES:
Apply thorough knowledge of ICD-10-CM and HCPCS/CPT coding theory with sustained accuracy of 95% or greater, while consistently maintaining acceptable productivity metrics set for the Professional Coding team.
Knowledge of E&M coding guidelines for both clinic/outpatient and inpatient services
Apply a thorough knowledge of medical terminology, disease process, and anatomy and physiology.
Communicate clearly and concisely both orally and in writing with all staff, physicians, and patients in all aspects of the job to allow efficiency and promptness for patient care.
Ability to function independently, with minimal supervision, as well as part of a team
Type 30 wpm with at least 90% accuracy.
Make rapid and accurate arithmetic calculations.
Maintain current and accurate records.
Treat information in patient records with strict confidentiality.
strong attention to detail and critical thinking skills,
REQUIRED QUALIFICATIONS:
High school diploma or equivalent required.
Certified Professional Coder certification (CPC or CPC-A) required.
PREFERRED QUALIFICATIONS:
Minimum of one year of recent applicable experience in coding with ICD-10-CM, and HCPCS/CPT preferred.
Extensive knowledge of medical terminology, disease process and anatomy and physiology preferred.
Experience working in Electronic Medical Record (EMR) preferred.
Working knowledge of 1500 vs. UB04 billing preferred.
Other Duties: This job description incorporates the essential functions and duties required for this position. However, other duties may be required and assigned at times and as determined by a supervisor in order to meet the needs of the organization.
Serves as a role model in carrying out activities and behaviors that reflect the values and principles of the Boys Town mission.
PHYSICAL REQUIREMENTS, EQUIPMENT USAGE, WORK ENVIRONMENT:
Position is relatively sedentary in a normal office administrative environment involving minimum exposure to physical risks. Will use office equipment such as a computer/laptop, monitor, keyboard, and a general workstation set-up.
Care and respect for others is more than a commitment at Boys Town – it is the foundation of who we are and what we do.
At Boys Town, we cultivate a culture of belonging for all employees that respects their individual strengths, views, and experiences. We believe that our differences enable us to be a better team – one that makes better decisions, drives innovation, and delivers better business results.
About Boys Town:
Boys Town has been changing the way America cares for children and families since 1917. With over a century of service, our employees have helped us grow from a small boardinghouse in downtown Omaha, Nebraska, into one of the largest national child and family care organizations in the country. With the addition of Boys Town National Research Hospital in 1977, our services branched out into the health care and research fields, offering even more career opportunities to those looking to make a real difference.
Our employees are our #1 supporters when it comes to achieving Boys Town's mission, which is why we are proud of their commitment to making the world a better place for children, families, patients, and communities. A unique feature for employees and their dependents enrolled in medical benefits are reduced to no cost visits for services performed by a Boys Town provider at a Boys Town location. Additional costs savings for the employee and their dependents are found in our pharmacy benefits with low to zero-dollar co-pays on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider. We help our employees prepare for retirement with a generous match on their 401K or 401K Roth account. Additional benefits include tuition reimbursement, parenting resources from our experts and professional development opportunities within the organization, just to name a few. Working at Boys Town is more than just a job, it is a way of life.
This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and/or expression, national origin, age, disability, or veteran status. To request a disability-related accommodation in the application process, contact us at 1-877-639-6003.
