Coder 3

Fairview Health Services is seeking a Coder 3 to join our Outpatient Coding team. This is a full-time, benefit-eligible position aligned with our Midway Campus in St. Paul, Minnesota. The role primarily supports standard daytime hours of 8:00 a.m. to 4:30 p.m., with occasional weekend rotation coverage as needed.

The ideal candidate will possess a strong understanding of anatomy and demonstrate advanced coding knowledge and attention to detail in a fast-paced healthcare environment.

This is a clinical or hospital-based coding position for an experienced coder working with specialty professional or hospital outpatient accounts. OP Coder 3 will competently assign ICD-10-CM, CPT-4, HCPCS codes to more complex outpatient accounts for billing, internal and external reporting, research, and regulatory compliance. Utilizes an encoder and/or computer assisted coding (CAC) software to achieve accurate and thorough coding. Is responsible for assigning APC weights, resolving medical necessity edits, and extracting data for the medical record abstract. Researches complex coding scenarios. OP Coder 3 analyzes clinical documentation; assigns appropriate diagnosis, procedure and level of service codes; and abstracts the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. 

Responsibilities

• Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
• Actively participates in creating and implementing workflow improvements.
• Assigns ICD-10-CM, CPT-4, or HCPCS codes to all diagnoses, treatments, and procedures on complex hospital outpatient or clinical department visits.
• Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned.
• Is able to research and understand simple and moderately complex coding issues.
• . Is proficient in using various coding software. Is able to problem solve simple computer issues.
• Utilizes technical coding principles and/or APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT-4 procedures. Assigns modifiers to CPT codes.
• Extracts required information from electronic medical record and enters into coding software and abstracting system.
• If applicable, identifies chargeable items for department visits and enters into computer system.
• Follows-up on unabstracted accounts to assure timely billing and reimbursement.
• Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication.
• May query physicians on documentation according to established procedures and guidelines.
• Meets productivity and quality standards as established by coding managers.
• Educate multidisciplinary team members, including physicians, about frequently changing mandated rules, regulations and guidelines to ensure a compliant claim.
• Identify and resolve clinical documentation and charge capture data discrepancies to improve quality of the clinical documentation, complexity of reimbursement levels assigned, and integrity of data reported.
• Performs other responsibilities as needed/assigned.
• Timely and accurate work.
• Contributes to the process or enablement of collecting expected payment.
• Understands and Adheres to Revenue Cycle’s Escalation Policy.
• Organization Expectations, as applicable:
• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
• Partners with patient care giver in care/decision making.
• Communicates in a respective manner.
• Ensures a safe, secure environment.
• Individualizes plan of care to meet patient needs.
• Modifies clinical interventions based on population served.
• Provides patient education based on as assessment of learning needs of patient/care giver.

Required Qualifications

• Completion of an accredited coding certificate program or a Health Information Technician program.
• 2 years of coding experience
• Outpatient or Professional Fee Coding: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist – Professional (CCS-P) or Certified Professional Coder - Hospital (CPC-H) or Certified Outpatient Coder (COC) or AAPC specialty certifications

Preferred Qualifications

• Associate of Science in Health Information
• Bachelor of Science in Health Information
• 2 years of coding experience with a variety of professional and hospital accounts – i.e. Observation, Surgical outpatients, Interventional Radiology, Heart Catheterization, Professional billing surgical specialty