Ambulatory Procedure Coding Specialist

Ambulatory Procedure Coding Specialist

Position Summary

This position is responsible for final coding of ambulatory procedure accounts. Must be a proficient with assigning ICD-10-CM diagnosis codes and CPT / HCPCS procedure codes to complex outpatient encounters including : interventional cardiology, radiology and pulmonary cases, same day surgery cases, and observation visits. Attention to detail is required for accurate capture of data elements in compliance with regulatory guidelines and billing rules.

Education

Associates - Preferred

Experience

1 - 2 Years Hospital or clinic based coding experience - Required

Must have relevant experience with assignment of surgical CPT / HCPCS codes.

License & Certification

One of the following is required;

Certification from American Health Information Management Association (AHIMA) RHIA, RHIT, CCS, CCA or American Academy of Professional Coders (AAPC) CPC or COC

OR

20 years medical coding experience, verified by employment references

Core Job Functions

• Accurately reviews medical records and assigns diagnosis and procedure codes utilizing the computerized encoding software system; assigns appropriate modifiers; reviews and resolves correct coding initiative and outpatient code edits; sequences codes to group to the correct APC. Validates admission and discharge data; reviews charges and pre-authorization data; abstracts other required data.
• Follows the standards of professionalism set forth by AHIMA and AAPC. Ethically and accurately assigns diagnosis and procedure codes in compliance with the ICD-10-CM Official Coding Guidelines, Coding Clinic, and CPT procedure codes in accordance with the CPT guidelines and CPT Assistant guidance.
• Reviews record for missing documentation that prevents final coding and places the account on hold. Monitors accounts on hold.
• Maintains certification and engages in continuing education activities. Stays up-to-date on coding changes, CPT Assistant guidance, Coding Clinic for HCPCS advice, and payor regulations including national and local policies. Shares knowledge with the rest of the team.
• Able to work independently and maintain quality and productivity standards in a remote, HIPAA compliant home environment to ensure goals are met. Identifies and escalates any obstacles to fulfilling job responsibilities. Takes initiative to resolve technical issues and maintains strong communication with coding management.

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