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Hello, We Are ruralMED!
Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.
The Hospital Outpatient Coder will be primarily responsible for hospital OP coding including ER (and associated professional fees), surgical, lab, radiology, and infusion. They will ensure the timely and accurate coding of medical claims. Furthermore, they will ensure maximum reimbursement for services provided by utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.
How This Role Makes an Impact:
- Support hospitals within the evolving rural landscape to achieve excellence
- Be on a team of dedicated, driven experts, passionate to be the best in rural healthcare through demonstrated coding excellence
- Apply problem-solving and critical thinking skills to develop processes and workflows, further enhancing efficacy and accuracy
- Help hospitals maximize reimbursement while supporting the patients with payor communications and accurate payout
What It’s Like Working at ruralMED:
- Our elite and highly skilled team is driven by delivering top-notch results and supporting each other to reach a new level of excellence while making a positive impact on our clients and rural healthcare.
- Discover flexibility and autonomy with a company that understands the true value and benefits of achieving work-life balance.
- Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool for achieving brilliance.
- Our core values are not only motivational they are the standard for how we conduct and take pride in our work.
- It Begins With You: Own It.
- Pave the Way. Never Settle.
- Be Thoughtful. Be Transparent. Be Extraordinary.
- Work Fearlessly. Celebrate the Wins.
- Capitalize Our Strengths. Achieve Excellence.
- Learn more about our team: https://ruralrevcycle.com/join-our-team/
How to Succeed in this Role:
- Excellent analytical, critical thinking, and problem-solving skills
- Ability to take direction and work independently
- 2-5 years medical coding experience (required)
- Strong communication and collaboration skills
- Possess demonstrated advanced coding abilities
- Knowledge of critical access hospital coding; emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic
- Natural ability to quickly and effectively adjust to changing priorities
- Character Traits: solution-based, self-motivated, positive, genuine, driven, responsible
Title: Hospital Outpatient Coder
Department: Revenue Cycle
Reports To: Revenue Cycle Supervisor/Lead Medical Coder & Audit Specialist/CBO Site Manager
Status: Full-time
Position Summary:
The Hospital Outpatient Coder will be primarily responsible for hospital OP coding including ER (and associated professional fees), surgical, lab, radiology and infusion. They will ensure the timely and accurate coding of medical claims. Furthermore, they will ensure maximum reimbursement for services provided by utilizing sound knowledge of coding rules and regulations, best practice workflows, and the use of multiple software systems.
**NOTE: A Coding Competency Assessment Test will be provided for qualified applicants prior to their first interview
Qualifications:
Education and/or Experience:
• High School Diploma is required, Associates is preferred.
• Two to five years medical coding experience is required.
Licenses/Certifications Required:
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.
General Requirements/Job Duties:
Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Specific job duties will vary based upon client assignment. Employee will also abide by ruralMED’s policies as a condition of employment.
Charge Entry
- Receive and review charge entry data from practice sites.
- Identify and investigate incomplete or missing charges.
Coding:
- Abstracts clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems.
- Sequences codes according to established guidelines.
- Thoroughly analyzes and interprets medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement.
- Conducts training for physicians/staff on coding and or documentation practices.
Other:
- Maintains current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers.
- Maintains proficient knowledge of EHR, as well as any other systems, required for performing required job duties.
- Communicates issues to management, including payer, system, or escalated account issues. Identifies medical necessity denial trends and provide suggestions for resolution.
- May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution.
- Participates in department meetings, in-service programs, and continuing education programs.
- Maintains a professional attitude with patients, visitors, physicians, office staff and hospital personnel. Assures confidentiality of patient information, maintaining compliance with policies and procedures.
- Performs other duties as assigned.
Required Knowledge, Skills and Abilities:
- Knowledge of medical terminology is required.
- Proficient with Microsoft Office
Security/Access:
Equipment Used:
Patient Age Groups Served:
None.
Essential Work Environment & Physical Requirements:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
