Rochester Regional HealthRH

Coder - Outpatient

Rochester Regional Health is a comprehensive healthcare system in Rochester, NY, dedicated to improving the health of the communities it serves through integrated medical services and compassionate care.

Rochester Regional Health

Employee count: 5000+

Salary: 40k-56k USD

United States only

Position Summary:

Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and/or CPT codes for billing, internal and external reporting, research, and regulatory compliance. Under the direction of the HIM Coding Manager, accurately codes conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting and/or CPT Assistant. Demonstrates knowledge of reimbursement methodologies and applies to assigned charts in order to optimize reimbursement and/ or resolve regulatory edits. Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors.

Key Responsibilities:

  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines and keeps abreast of coding changes and interpretation of codes.
    • Complies with RRH & HIM department policies & procedures
    Reviews appropriate provider documentation to identify & assign diagnoses & surgical procedure or treatment codes using ICD-10-CM and CPT procedure codes as defined in facility specific guidelines.
    • Meets established departmental productivity guidelines for the specific type of coding being performed with 95% accuracy on a consistent basis.
    • Utilizes Care Connect, UDS and Clintegrity systems proficiently to obtain ICD10-CM and CPT codes
    • Utilizes technical coding principals and APC/E-APG reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT procedure codes
    • Formulates compliant coding queries when documentation is inadequate, ambiguous or unclear for coding purposes
    • Enters and/or updates data accurately in various systems as departmental policy indicates.
    • Completes other duties as assigned by HIM leadership.
    • Provide assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process
    • Assigns appropriate discharge disposition and/or modifiers based on established coding guidelines.
    • Analyzes clinical documentation to determine charge capture requirements for numerous clinical services.
    • Uses reports and application queues to identify targeted accounts on a daily basis. Works with CDM team to ensure appropriate charges are in place and that associated CPT codes are current.
    • Corrects failed claim errors to billing edits, accounts misclassified and/or other errors identified through various auditing processes in a timely manner.
    • Attends RGHS, HIM Department and Coding Team meetings and training sessions as required.
    • Ensure timely reporting for external regulations


    Required Licensure/Certification Skills:
    Advance coding certification credential: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder Hospital Based (CPC-H), Certified Medical Coder (CMC), RHIT/RHIA certification, Radiology Certified Coder (RCC), Certified Coding Associate (CCA), Certified Outpatient Coding (COC), Certified Inpatient Coder (CIC), Certified Risk Adjustment Coder (CRC), Certified Professional Coder-Payer (CPC-P), or any of the specialty coding certifications offered by AAPC (CASCC, CANPC, CCC, CCVTC, CCPC, CPCD, CEDC, CEMC, CFPC, CGIC, CGSC, CHONC, CIMC, CIRCC, COBGC, COPC, COSC, CENTC, CPEDC, CPRC, CRHC, CSFAC, CUC), Ophthalmic Coding Specialist (OCS) - American Academy of Ophthalmology.
    - Will consider RHIT eligible candidate who sits for the exam within one year of hire
    Full CPC certification must be obtained within 24 months if employee holds CPC-A from the American Academy of Professional Coders (AAPC) at time of hire or 36 months after certification if obtained after employment.
    - For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification required within 16 months of hire.

EDUCATION:

AS: Health Information Management (Required)

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$20.75 - $28.50

CITY:

Rochester

POSTAL CODE:

14617

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.
Minority/Female/Disability/Veterans by a prospective employee and/or employee’s Physician or delegate will be considered for accommodations.

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Entry-level

Salary

Salary: 40k-56k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Rochester Regional Health

Learn more about Rochester Regional Health and their company culture.

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Rochester Regional Health is a leading integrated health system located in Rochester, New York, committed to serving the health needs of local communities across Western, Central, and Northern New York. Established in 2014 through the merger of Rochester General Health System and Unity Health System, the organization has grown to become a major constituent of the healthcare landscape in the region, providing a full spectrum of services from emergency care to long-term rehabilitation. The health system focuses on high-quality, compassionate care, leveraging advanced technology and a dedicated workforce to ensure that patient care is both comprehensive and accessible.

The breadth of Rochester Regional Health includes nine hospitals, over 500 outpatient locations, urgent care sites, and specialized health services. The system operates a variety of programs such as ElderONE/PACE and provides extensive cancer care, all tailored to meet the diverse needs of the populations it serves. Rochester Regional Health is deeply committed to community health, striving towards improving healthcare equity and meeting the unique needs of its patient population.

Claim this profileRochester Regional Health logoRH

Rochester Regional Health

Company size

5000+ employees

Founded in

2014

Chief executive officer

Richard "Chip" Davis, Ph.D.

Employees live in

View company profile

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Rochester Regional Health hiring Coder - Outpatient • Remote (Work from Home) | Himalayas