ASU Coder II

Job Description

Summary

Position Summary
This is the second level of a 4-tier career path. Under the general direction of the Coding Director, this position is responsible for the accurate assignment of ICD-10-CM and CPT-4 coding of diagnoses and procedures for outpatient medical records in the Ambulatory Surgery setting of a Level 1 Trauma Facility and Teaching Hospital. This position performs complex surgical coding in support of specialty or multi-specialty physician practices and OPPS and CAH hospitals. The position includes performing abstracting to determine accuracy and completeness of the outpatient record, utilizing the 3M Coding Reimbursement, other external encoder tools and Epic EMR systems to compile data. The Surgical Coder evaluates medical necessity and National Correct Coding Initiative edits and resolves them accurately. Data reported is used to meet licensure requirements, statistical purposes and reimbursement purposes.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
Education: Associates degree in science field strongly preferred with completion of an accredited program through AHIMA or AAPC.
License/Certifications: RHIT, RHIA, CCS, CCA, CPC, CPC-H,CASCC or CIRCC credential required.
Experience: Minimum of two (2) years of multi-specialty, preferably surgical coding experience, with CPT/ICD-9-CM/HCPCS/modifier coding for physician professional charges and a minimum of two (2) years’ experience in an acute care facility as a Clinical Coder II or equivalent. Required experience coding Surgical Observations, ASU, Professional Surgical CPT’s or any combination of these areas. Level 1 Trauma Facility coding experience preferred. This position performs complex surgical coding in support of specialty or multi-specialty physician practices and OPPS and CAH hospitals. Single Path Coding experience preferred.
Proficiencies: Must demonstrate an elevated level of knowledge of ICD-10-CM, CPT-4 and HCPCS coding guidelines and principles required. Employee has the ability to demonstrate competence and knowledge-base through the utilization of a standardized test with a minimum of 95% accuracy while meeting productivity requirements. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding. Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.
Specialized Knowledge: Strong ability to apply broad guidelines to specific coding situations, independently, utilizing discretion and a significant level of analytical ability. Advanced knowledge base of anatomy and physiology. Must demonstrate excellent critical thinking and organization skills. Requires attention to detail. Experience working in an integrated delivery system, multi-hospital system a plus. Epic Experience preferred.
Additional Information

MaineHealth is a health system whose members and affiliates include hospitals, physician practices, long-term care facilities, home care agencies, and support services. Learn more about this system at www.mainehealth.org