Outpatient Coding Specialist II (Remote)
Stanford Health Care, Palo Alto, CA, United States
Overview
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is a Stanford Health Care job. What you will do
Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, CPT codes and modifiers as applicable, leading to the assignment of the correct Ambulatory Payment Classification (APC). The Outpatient Coding Specialist II is responsible for validating and working any medical necessity edits that are applicable in the coding of the outpatient account. Additionally responsible for verification of the patient’s discharge disposition and correct source of admission for state reporting purposes. If applicable to outpatient type, responsible for coding, following established conventions and guidelines, codes and abstracts the medical records of day surgery and outpatient records. Assists with coding and leveling ERs as needed. Assists with coding and charging infusion cases as needed. Keeps work queues within established date goals. Codes procedures as appropriate and identifies the principal procedure consistent with established coding guidelines. Validates outpatient accounts for medical necessity based on local coverage determination policies (LCDs) or national coverage determinations (NCDs). Applies charge data as appropriate for services provided. Correctly abstract required data per facility specifications. Responsible for monitoring Discharged Not Billed accounts, and as a team, ensure timely, compliant processing of inpatient accounts through the revenue cycle. Collaborates with Clinical Documentation Specialists (CDSs) and members of the medical staff to ensure completeness of documentation in the medical records so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG) may be assigned. Demonstrates independence, strong time management, problem solving and communication skills. Maintains accuracy while utilizing tools of the trade, such as the 3M encoder, 3M Audit Expert process, 3M CDIS, and other software to compile and validate medical information. Responsible for validating and working any medical necessity edits that apply in the coding of outpatient accounts, and for identifying and reporting error patterns, and, when necessary, assisting in design and implementation of workflow changes to reduce billing errors. Locations
Stanford Health Care Qualifications
Education Qualifications
High School Diploma or GED Experience Qualifications
Three years, must be able to code most (at least 3) outpatient services Required Knowledge, Skills and Abilities
Successful completion of the Coder Proficiency Exam (pre-hire) Ability to adapt to and deal with change and ambiguity Ability to plan, organize, prioritize, work independently and meet deadlines Ability to comply with AHIMA Code of Ethics and Standards and UHDDS standards Ability to establish and maintain effective working relationships Ability to manage, organize, prioritize, multi-task and adapt to changing priorities Ability to solve technical and non-technical problems Ability to utilize ICD-10-CM/PCS and CPT-4 coding conventions to code medical record entries; abstract information from medical records; read medical record documentation; assign accurate codes for grouping of MS-DRGs and APR-DRGs Ability to work effectively with others at all levels of the organization Knowledge of diagnosis/procedure DRG grouping schemes such as MS-DRGs and APR-DRGs Knowledge of health information systems for computer application to medical records Knowledge of CCI and CMS compliance issues Knowledge of computer systems and software used in the functional area Knowledge of standards and regulations pertaining to the maintenance of patient medical records; medical records coding systems; medical terminology; anatomy and physiology and study of diseases Licenses and Certifications
RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CCS - Certified Coding Specialist or CPC and/or CCSP - Certified Professional Coder or COC Policy and Standards
These principles apply to ALL employees: SHC Commitment to Providing an Exceptional Patient & Family Experience Note: The following text reflects SHC standards for patient experience and the C-I-CARE framework. It explains three experience pillars but is included here as part of the overall role description. Know Me: Anticipate my needs and status to deliver effective care
Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
Coordinate for Me: Own the complexity of my care through coordination
Equal Opportunity Employer
Stanford Health Care strongly values diversity and is committed to equal opportunity and non-discrimination in all policies and practices, including employment. SHC does not discriminate based on race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability. People of all genders and backgrounds are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and job requirements. Base Pay Scale: Generally starting at $52.37 - $58.98 per hour The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. At Stanford Health Care, we seek to provide patients with the very best in diagnosis and treatment, with outstanding quality, compassion and coordination. With an unmatched track record of scientific discovery, technological innovation and translational medicine, Stanford Medicine physicians are pioneering leading edge therapies today that will change the way health care is delivered tomorrow. As part of our spirit of discovery, we also leverage our deep relationships with luminary Silicon Valley companies to develop new ways to deliver preeminent patient care. Learn about our awards and significant events at Stanford Health Care.
#J-18808-Ljbffr
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is a Stanford Health Care job. What you will do
Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, CPT codes and modifiers as applicable, leading to the assignment of the correct Ambulatory Payment Classification (APC). The Outpatient Coding Specialist II is responsible for validating and working any medical necessity edits that are applicable in the coding of the outpatient account. Additionally responsible for verification of the patient’s discharge disposition and correct source of admission for state reporting purposes. If applicable to outpatient type, responsible for coding, following established conventions and guidelines, codes and abstracts the medical records of day surgery and outpatient records. Assists with coding and leveling ERs as needed. Assists with coding and charging infusion cases as needed. Keeps work queues within established date goals. Codes procedures as appropriate and identifies the principal procedure consistent with established coding guidelines. Validates outpatient accounts for medical necessity based on local coverage determination policies (LCDs) or national coverage determinations (NCDs). Applies charge data as appropriate for services provided. Correctly abstract required data per facility specifications. Responsible for monitoring Discharged Not Billed accounts, and as a team, ensure timely, compliant processing of inpatient accounts through the revenue cycle. Collaborates with Clinical Documentation Specialists (CDSs) and members of the medical staff to ensure completeness of documentation in the medical records so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG) may be assigned. Demonstrates independence, strong time management, problem solving and communication skills. Maintains accuracy while utilizing tools of the trade, such as the 3M encoder, 3M Audit Expert process, 3M CDIS, and other software to compile and validate medical information. Responsible for validating and working any medical necessity edits that apply in the coding of outpatient accounts, and for identifying and reporting error patterns, and, when necessary, assisting in design and implementation of workflow changes to reduce billing errors. Locations
Stanford Health Care Qualifications
Education Qualifications
High School Diploma or GED Experience Qualifications
Three years, must be able to code most (at least 3) outpatient services Required Knowledge, Skills and Abilities
Successful completion of the Coder Proficiency Exam (pre-hire) Ability to adapt to and deal with change and ambiguity Ability to plan, organize, prioritize, work independently and meet deadlines Ability to comply with AHIMA Code of Ethics and Standards and UHDDS standards Ability to establish and maintain effective working relationships Ability to manage, organize, prioritize, multi-task and adapt to changing priorities Ability to solve technical and non-technical problems Ability to utilize ICD-10-CM/PCS and CPT-4 coding conventions to code medical record entries; abstract information from medical records; read medical record documentation; assign accurate codes for grouping of MS-DRGs and APR-DRGs Ability to work effectively with others at all levels of the organization Knowledge of diagnosis/procedure DRG grouping schemes such as MS-DRGs and APR-DRGs Knowledge of health information systems for computer application to medical records Knowledge of CCI and CMS compliance issues Knowledge of computer systems and software used in the functional area Knowledge of standards and regulations pertaining to the maintenance of patient medical records; medical records coding systems; medical terminology; anatomy and physiology and study of diseases Licenses and Certifications
RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CCS - Certified Coding Specialist or CPC and/or CCSP - Certified Professional Coder or COC Policy and Standards
These principles apply to ALL employees: SHC Commitment to Providing an Exceptional Patient & Family Experience Note: The following text reflects SHC standards for patient experience and the C-I-CARE framework. It explains three experience pillars but is included here as part of the overall role description. Know Me: Anticipate my needs and status to deliver effective care
Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
Coordinate for Me: Own the complexity of my care through coordination
Equal Opportunity Employer
Stanford Health Care strongly values diversity and is committed to equal opportunity and non-discrimination in all policies and practices, including employment. SHC does not discriminate based on race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability. People of all genders and backgrounds are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and job requirements. Base Pay Scale: Generally starting at $52.37 - $58.98 per hour The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. At Stanford Health Care, we seek to provide patients with the very best in diagnosis and treatment, with outstanding quality, compassion and coordination. With an unmatched track record of scientific discovery, technological innovation and translational medicine, Stanford Medicine physicians are pioneering leading edge therapies today that will change the way health care is delivered tomorrow. As part of our spirit of discovery, we also leverage our deep relationships with luminary Silicon Valley companies to develop new ways to deliver preeminent patient care. Learn about our awards and significant events at Stanford Health Care.
#J-18808-Ljbffr