JOB SUMMARY

• Coder I is proficient in one or two types of outpatient or profee coding.
• Coder I may code one time ancillary/series, emergency department, observation, day surgery, professional fee to include evaluation and management (E/M) coding, profee surgery, hierarchical condition category (HCC) Risk Adjusted coding (diagnosis only with 1 year lookback) or low acuity inpatient.
• Coder I utilizes the International Classification of Disease (ICD-10-CM. ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.)
• Coder I will abstract and enter required data.

WORK MODEL

• Onsite with the possibility of moving to a hybrid role after training has been signed off, but will not be 100% remote.

ESSENTIAL FUNCTIONS OF THE ROLE

• Evaluates and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees.
• Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
• Communicates with providers for missing documentation elements and offers guidance and education when needed.
• Reconcile billing issues by formulating the rationale for rejecting and correcting inaccurate charges.
• Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately. Reviews and edits charges.

KEY SUCCESS FACTORS

• Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
• Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
• Sound knowledge of anatomy, physiology, and medical terminology.
• Demonstrated expertise of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
• Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
• Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
• Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.

BENEFITS

Our competitive benefits package includes the following

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 1 Year of Experience
  • This position is not under the Coding umbrella but an outpatient practice therefore, some sort of coding experience is required.
• CERTIFICATION/LICENSE/REGISTRATION -
  • Cert Coding Assoc.
  • Cert Coding Specialist
  • Cert Coding Specialist-Phys
  • Cert Inpatient Coder
  • Certified Inpatient Coder - Apprentice
  • Cert Outpatient Coder
  • Cert Outpatient Coder - Apprentice - Cert Interv Rad CV Coder
  • Cert Prof Coder
  • Cert Prof Coder-Apprentice
  • Cert Prof Coder-Phys
  • Home Care Coding Spec-Diagn
  • Reg Health Info Admin
  • Reg Health Info Technician
  • Radiation Oncology Certified Coder HCS-D is valid in Home Health Care Department only.
    • ROCC is valid for Radiation Oncology only.

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About Baylor Scott & White Health

Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!

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