Remote Medical Coder Outpatient

BASIC FUNCTION AND RESPONSIBILITY

Extract and analyze clinical information and translate into the most accurate ICD-10-CM, CPT, and other specialized codes and modifiers to ensure appropriate reimbursement and accurate and reliable data for research, statistics, financial planning, compliance, and marketing. Make corrections to coding edits and charges.

CHARACTERISTIC DUTIES AND RESPONSIBILITIES

PROCESS - EXECUTION - OPERATIONS

Extract, review, and analyze clinical information, identify, and abstract all pertinent information and translate data into appropriate ICD-10-CM, CPT, and other specialized codes and modifiers for appropriate reimbursement, research, statistics, financial planning, compliance and marketing to ensure completeness, accuracy and compliance with established guidelines of all governmental regulatory agencies and third-party payers. Work under fast-paced circumstances to meet turnaround time requirements. Meet or exceed departmental/unit performance standards. 60%

Exercise independent judgment on determining case complexity by utilizing clinical knowledge in order to understand the etiology, pathology, signs, symptoms, diagnostic studies, treatment modalities and prognosis of diseases and procedures to be coded. Research complex diagnoses and/or procedures as needed to enhance coding knowledge to consistently apply the correct codes. Identify issues and make recommendations for resolution and improvement. Escalate patient safety, customer service, quality, and compliance concerns to leadership. Communicate with unit leadership regarding policy and procedures. 20%

Interact closely with providers and query the medical staff appropriately and professionally to obtain accurate documentation necessary to ensure coding compliance and accuracy. 10%

Expand job-related knowledge and skills by attending and participating in in-services and staff meetings. Maintain currency with work processes, tools, and clinical and administrative applications necessary to perform job functions, including, but not limited to, keeping abreast of coding guidelines and quarterly Coding Clinic and monthly CPT Assistant. Demonstrate an understanding of University, Michigan Medicine, departmental, and unit policies and procedures and seeks clarification as needed. Comply with regulatory, legal, and accreditation requirements and seeks clarification as needed. Assure adherence with safety programs. Participate in and demonstrate an understanding of a highly reliable organization and applies quality improvement concepts in daily work. 10%

PROBLEM SOLVING

Demonstrate a commitment to a highly reliable organization for problem analysis and improvement.

Participate in quality improvement efforts related to coding processes.

Participate in process improvement and redesign to improve customer satisfaction, reduce costs, and/or meet departmental and institutional goals and objectives.