Outpatient Coder II

The Outpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. Follows ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinics, interprets ICD-10-CM coding conventions and instructional notes to select appropriate diagnoses with a minimum of 95% accuracy.  Meets established minimum coding productivity per departmental protocol and guidelines. The Outpatient Coder II is the coding and reimbursement expert with ICD-10-CM diagnosis coding, HCPCS and CPT codes and modifiers. The focus is on complex outpatient encounters that include Observation stays, Same Day Surgery, Surgery Center, and Outpatient in a bed. Coder II should have knowledge and expertise of Coder Associate and Coder I. Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types. Reviews the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses and procedures. Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, and medical terminology to report appropriate diagnoses and/or procedures. Sends appropriate physician queries when required for documentation clarification. Follows Coding Clinic for HCPCs, CPT Assistant, and interprets coding conventions and instructional notes to select appropriate diagnoses and procedures with a minimum of 95% accuracy. Broad focus of anatomy on entire body system. Resolves NCCI Edits with approved hospital modifiers, utilizing 3M Encoder resources to ensure optimal coding accuracy.