Remote Outpatient Medical Coder

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

The Remote Outpatient Medical Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. This position is 100% remote.

• Demonstrates the ability to perform quality coding on ancillary, clinic, emergency room / E&M and outpatient surgery records.

• Maintains a working knowledge of ICD-10-CM and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.

• Assures that all services documented in the patient’s chart are coded with appropriate ICD-9/ICD-10 and CPT codes.  When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards.

• Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity.  Accuracy will be monitored during monthly reviews either within the facility. 

• Ability to maintain average productivity standards as follows:  Emergency Room Records with E/M 13 charts per hour, emergency room records without E/M 17 per hour, clinic records 16 charts per hour, ancillary/diagnostic 28 charts per hr., outpatient surgery records 5 per hr.  (These productivity standards are Guidehouse’ general expectations and are subject to change based upon Guidehouse client agreements and/or other factors as determined by management.  Notification of expected productivity will be conveyed by Management prior to assignment of a client project). 

• Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary.

• Charts that require re-bills are corrected and communicated to the facility daily for the rebill process.  See re-bill policy in facility guidelines.

• Provides accurate answers to physician’s/hospitals coding and/or billing questions

• Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy).

What You Will Need:

• Minimum 3-5 years previous outpatient facility coding experience

• Minimum 3-5 years previous ICD-10 and CPT medical coding experience

• Must have one …