Remote OP Coder

Remote Op Coder

The Op Coder works outpatient coding related alerts / edits for Same Day Surgery, Observation, and Wound Care, accounts, predominately post initial / final coding. The CARS-II performs the alert / edit resolution activities in the applicable systems. The alerts / edits shall be worked and corrected according to the established procedures and thresholds, and communicated as appropriate.

Position Duties :

• Compiles daily work list from eRequest, CRT and / or other alert / edit systems
• Takes action and resolves alerts / edits for the following patient types following established procedures and thresholds :
• Same Day Surgery (SDC)
• Observation (OBV)
• Wound Care
• Outpatient Cardiac Cath
• Provides back up / coverage as needed for :
• Emergency Dept (ED)
• Recurring (RCR)
• Clinical (CLI)
• Provider Office Visit (POV), as applicable
• Enters detailed notes to update eRequest to provide details if the alert / edit cannot be resolved or must be rerouted to another responsible party for research / resolution
• Communicates coding revisions to the applicable party (e.g., CIS, lead, manager, international log)
• Completes MOCK abstracts as necessary (e.g., combining the codes for outpatient claims subject to the payment window)
• Assists the Coding Leads and / or Coding Managers in resolving unbilled reason codes (URC)
• As needed, may periodically be asked to perform Coding Integrity Specialist II (CIS-II) duties
• Periodically works with their Manager to review individual work accomplishments, discuss work problems / barriers, discuss progress in mastering tasks and work processes, and discusses individual training needs and career progression
• Adheres to all applicable coding and billing regulations and guidance, including but not limited to, CMS, AHA and HCA policies and guidelines
• Meets all educational requirements as stated in Company and HSC policy
• Reviews all official data quality standards, coding guidelines, Company policies and procedures and clinical / medical resources to assure coding knowledge and skills remain current
• Practice and adhere to the Company's Code of Conduct philosophy
• Practice and adhere to the Company's Mission and Values
• Other duties as assigned

Minimum Qualifications :

Preferred Qualifications : Recent 3-5 years acute care OP Coding - Same Day Surgery, Observation, IVR, Cardiology, Wound Care in an Academic Level I Trauma facility