Outpatient Coding Specialist

Software Guidance & Assistance, Inc., (SGA), is searching for an Outpatient Coding Specialist for a CONTRACT assignment with one of our premier Healthcare Services clients. This position is fully remote.

The Outpatient Coding Specialist is responsible to review and code outpatient medical records. The medical records are maintained in electronic format and will be coded according to current coding guidelines, and in compliance with organizational, departmental, and regulatory requirements. The Outpatient Coding Specialist is identified as a subject matter expert due to education, training, and experience and as such will receive coding assignments in accordance with that level of expertise. Additionally, the Outpatient Coding Specialist may be asked to mentor and proctor employees at the lower levels.

Responsibilities :

• Responsible for coding retrospective outpatient accounts using ICD-10 CM, CPT, HCPCS, and Modifiers in compliance with the Official Coding Guidelines and conventions.
• Accurately identifies most appropriate Reason for Visit, First Listed, and all Secondary Diagnosis as appropriate, and all Procedures as appropriate to support medical necessity and resolve LCD, NCD, and CCI edits.
• Validates charge-master driven CPT code assignments and routes appropriately.
• Accurately abstracts required data elements including, discharge disposition, procedure dates and physician(s), applicable occurrence codes, and other designated data.
• Identifies when a physician query is appropriate for further clarification
• Recognizes when the documentation is missing or incomplete and routes appropriately
• Completes review and final coding when query and/or documentation is available
• Maintain the Quality Standards set by Facility/HIM Coding.
• Maintain the Productivity Standards set by Facility/HIM Coding.
• Mentor/train on designated coding service lines as requested to ensure quality.
• Maintains an expert level of knowledge of coding related guidelines and practices.
• Other duties as assigned

Required Skills :

• Three to five (3-5) years acute hospital based coding experience. An equivalent combination of education and experience may be considered.
• Experience working in a remote environment preferred; required for PRN Coders
• Advanced level of computer skills and knowledge
• Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), or AHIMA Certified Coding Specialist (CCS), AAPC Certified Outpatient Coder(COC), AAPC Certified Professional Coder (CPC)-Prior to 2014, or AAPC Certified Professional Coder-Hospital (CPC-H)

Preferred Skills :

• Preferred knowledge of 3M 360 and Epic.
• Bachelor's Degree or Associate Degree in Health Information Management and/or closely related field

SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements. When we say let's work better together, we mean it. You'll join a diverse team built on these core values: customer service, employee development, and quality and integrity in everything we do. Be yourself, love what you do and find your passion at work. Please find us at .

SGA is an Equal Opportunity Employer and does not discriminate on the basis of Race, Color, Sex, Sexual Orientation, Gender Identity, Religion, National Origin, Disability, Veteran Status, Age, Marital Status, Pregnancy, Genetic Information, or Other Legally Protected Status. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, and our services, programs, and activities. Please visit our company to request an accommodation or assistance regarding our policy.