Outpatient Facility CODER QUALITY ASSOCIATE HIMS Remote
Company: Banner Health
Location: Battle Creek
Posted on: November 19, 2022
Coding-Acute Care Compl & Educ
**Primary Location Salary Range:**
$25.77/hr - $38.66/hr, based on education & experience
In accordance with Colorado's EPEWA Equal Pay Transparency
A rewarding career that fits your life. As an employer of the
future, we are proud to offer our team members many career and
lifestyle choices including remote work options. If you're looking
to leverage your abilities - you belong at Banner Health.
Consider joining our **Outpatient Hospital Coder Quality Team** .
Banner Health is Arizona's largest employer and one of the largest
nonprofit healthcare systems in the country; and the leading
nonprofit provider of hospital services in all the communities we
serve. We have remote workers in 34 States and continue to grow!
There is endless opportunity to grow in Banner and make a life and
Are you a SUPERSTAR Outpatient Facility Coder who is ready to take
your skills to the next level? Our OUTPATIENT HOSPITAL CODING
QUALITY ASSOCIATE position is the perfect fit for you.
An ideal candidate has:
+ Proficiency in all levels of outpatient facility coding from
Diagnostics to Emergency Room, OP Surgery, and Observation.
+ 3-5 years' experience in recent facility OP
+ Experience in NCCI modifier application
+ Working knowledge of claim edits, LCD/NCD, and various claims
issues for the facility
+ ICD-10PCS coding, prior auditing, or staff mentoring experience
are a big plus!
In this remote **Outpatient** **Facility - Medical CODING QUALITY
ASSOCIATE** position, you **bring your 3-5+ years of acute care
outpatient coding background** **and make a big difference!**
This is a Quality position, not a day-to-day coding role. This
position entails a variety of tasks to support coders, ensure
quality coding, and utilizes a variety of programs to interact with
other members of the revenue cycle on claims issues. This is your
opportunity to take your OP coding skills to the next level and be
with a growing Healthcare organization that offers many
opportunities for advancement and growth. **CCS or CPC or CCS-P,
and/or RHIT or RHIA Coding Certification is Required** If you're
ready to change lives, including your own, we want to hear from
Banner Health provides your equipment when hired. You will be fully
supported through the training process lasting 1 - 3 months
according to individual experience, with continued support
throughout your career here!
**This is a fully remote position and available if you live in the
following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS,
KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN,
TX, UT, VA, WA, WI & WY.**
**We offer flexible hours as we have remote Coders across the
Nation. Generally, any 8-hour period between 6 am - 7 pm can
Within Banner Health Corporate, you will have the opportunity to
apply your unique experience and expertise in support of a
nationally-recognized healthcare leader. We offer stimulating and
rewarding careers in a wide array of disciplines. Whether your
background is in Human Resources, Finance, Information Technology,
Legal, Managed Care Programs or Public Relations, you'll find many
options for contributing to our award-winning patient care.
This position is responsible for the interpretation of clinical
documentation completed by the health care team for the health
record(s) and for quality assurance in the alignment of clinical
documentation and billing codes. Works with medical staff and
quality management staff to correctly align diagnosis documentation
and billing coding to improve the quality of clinical documentation
and correctness of billing codes prior to claim submission to third
party payers; to identify possible opportunities for improvement of
clinical documentation and accurate MS-DRG, Ambulatory Payment
Classification (APC) or ICD-9 assignments on health records.
Provides guidance and expertise in the interpretation of, and
adherence to, the rules and regulations for documentation.
1. Provides coding and guidance for non-standard billing.
Demonstrates extensive knowledge of clinical documentation and its
impact on reimbursement under Medicare Severity Adjusted System
(MS-DRG), and Ambulatory Payment Classification (APC) or utilized
operational systems Provides explanatory and reference information
to internal and external customers regarding clinical documentation
which may require researching authoritative reference information
from a variety of sources.
2. Reviews medical records. Performs a "Second Look" at clinical
documentation to ensure that clinical coding is accurate for proper
reimbursement and that coding compliance is complete. Monitors
coding work and trends, then provides education where opportunities
are identified. Reviews accuracy of identified data elements for
use in creating data bases or reporting to the state health
department. If applicable, applies Uniform Hospital Discharge Data
Set (UHDDS) definitions to select the principal diagnosis,
principal procedure, complications and co morbid condition, other
diagnoses, and significant procedures which require coding. Apply
policies and procedures on health documentation and coding that are
consistent with official coding guidelines.
3. Assists with maintaining system wide consistency in coding
practices and ethical coding compliance. If applicable, initiates
and follows through on attending physician queries to ensure that
the clinical documentation supports the patient's treatment and
outcomes. Identifies training needs for medical and coding staff.
Provides written updates and spreadsheets as to data findings.
Serves as a team member for internal coding accuracy audits.
4. Acts as a knowledge resource to ancillary clinical departments
and revenue integrity analysts regarding charge related issues,
processes and programming. Participates in company-wide quality
teams' initiatives to improve clinical documentation. Assists with
education and training of Coding Apprentice or other staff involved
in learning coding. Assists in creating a department-wide focus of
performance improvement and quality management. Assists and
participates with management through committees in order to
properly educate physicians, nursing, coders, CDM's, etc with
proper and accurate documentation for positive outcomes.
5. Performs ongoing audits/review of inpatient and/or outpatient
medical records to assure the use of proper diagnostic and
procedure code assignments. Provides findings for use as a basis
for development of HIMS compliance plans, education of clinical
coding staff and functional assessments.
6. Maintains a current knowledge in all coding regulatory updates,
and in all software used for coding and health information
management for the operational group. Monitors and evaluates trends
in DRG (MS-DRG), APC, ACG, DCG, HCC and other Health Risk Adjusted
Factors appropriate to the assigned area, and the effect on Case
Mix Index by use of specialized software.
7. As assigned, tracks and creates monthly reports for the Charge
Description Master Planning committee to identify coding and Health
Risk Adjusted Factors accuracies, potential revenue enhancement
areas, and identifies opportunities for education of staff.
8. May code inpatient and outpatient records as needed. Works as a
member of the overall HIMS team to achieve goals in
9. Works independently under limited supervision. Uses an expert
level of knowledge to provide billing guidance and oversight for
one or more medical facilities. Internal customers include but are
not limited to medical staff, employees, patients, and management
at the local, regional, and corporate levels. External customers
include but are not limited to, practicing physicians, vendors, and
Requires a level of education as normally demonstrated by a
bachelor's degree in Health Information Management and current
In an acute care setting, requires Certified Coding Specialist
(CCS) or Certified Professional Coder (CPC) or Certified Coding
Specialist-Physician (CCS-P) or Registered Health Information
Technologist (RHIT) or Registered Health Information Administration
(RHIA) in an active status with the American Health Information
Management Association (AHIMA) or American Academy of Professional
Demonstrated proficiency in hospital and/or multiple physician
specialty coding as normally obtained through 3-5 years of current
and progressively responsible coding experience required.
Experience normally obtained with 2-3 year experience in CMS HCC
Risk Adjustment payment methodology and coding and documentation
requirements. Must possess a thorough knowledge of ICD/DRG coding
and/or CPT coding principles, and the recommended American Health
Information Management Association coding competencies. Requires an
in-depth knowledge of medical terminology, anatomy and physiology,
plus a thorough understanding of the content of the clinical record
and an extensive knowledge of all coding conventions and
reimbursement guidelines across all services lines. Excellent
written and oral communication skills are required, as well as
effective human relations skills for building and maintaining a
working relationship with all levels of staff, physicians, and
Must consistently demonstrate the ability to understand the
Medicare Prospective Payment System, and the Clinical coding data
base and indices, and must be familiar with coding and abstracting
software, as well as common office software and the electronic
medical records software.
Additional related education and/or experience preferred.
Our organization supports a drug-free work environment.
Banner Health supports a drug-free work environment.
Banner Health complies with applicable federal and state laws and
does not discriminate based on race, color, national origin,
religion, sex, sexual orientation, gender identity or expression,
age, or disability
Keywords: Banner Health, Battle Creek , Outpatient Facility CODER QUALITY ASSOCIATE HIMS Remote, Other , Battle Creek, Michigan
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