Fairview Health Services has an opening for Outpatient Coder at the University Park building in St Paul. This is a part-time, day shift opportunity, 40hours/2 week pay period, with no weekends.
Based in the Twin Cities Metro area, this position will require residency within proximity of the workplace. As this position offers some ability to telecommute, it is the expectation the following requirements of the remote work policy will be met, including but not limited to:
Remote workspace that is clean, safe, and professional.
Maintains an internet connection consistent with Fairview standards at remote workspace.
Remain productive and responsive during their scheduled work hours.
Attend primary Fairview location, as needed.
Job Summary :
OP Coders analyze clinical documentation; assign appropriate diagnosis, procedure, and, in some cases, levels of service codes; and abstract the codes and other clinical data. Performs a variety of technical functions within the Hospital Outpatient coding area, codes ancillary outpatient visits, home health, hospice, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM and CPT-4 Coding Classification systems. Utilizes an encoder and computer assisted coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits, and extracting and entering data into the medical record abstract for a variety of like outpatient visit types similar to those listed above. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. OP Coding also resolve clinical documentation and charge capture discrepancies, and provide feedback to providers on the quality of their documentation and charging.
Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
Actively participates in creating and implementing improvements.
Assigns ICD-10 or CPT codes to all diagnoses, treatments, and procedures, according to official coding guidelines.
Validates computer assisted coding (CAC) generated and suggested codes in conjunction with encoder.
Extracts required information from electronic medical record and enters into encoder and abstracting system.
Follows-up on unabstracted accounts to assure timely billing and reimbursement.
Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. May query physicians on documentation according to established procedures and guidelines.
Meets productivity and quality standards as specified by manager.
Review OASIS documentation for accuracy.
Provide on-going learning to staff regarding coding practices.
Complete projects as assigned.
Share payer specific guidelines to ensure correct coding.
Performs other responsibilities as needed/assigned.
Organization Expectations, as applicable:
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
Partners with patient care giver in care/decision making.
Communicates in a respective manner.
Ensures a safe, secure environment.
Individualizes plan of care to meet patient needs.
Modifies clinical interventions based on population served.
Provides patient education based on as assessment of learning needs of patient/care giver.
Fulfills all organizational requirements
Completes all required learning relevant to the role
Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
Fosters a culture of improvement, efficiency and innovative thinking.
Performs other duties as assigned
The following are job expectations and qualifications in addition to those noted on the core job description.
Addendum Job Expectations:
Resolving medical necessity edits, payor coding denials, and extracting and entering data into the medical record abstract for Outreach outpatient visits.
Obtains principle symptom or diagnosis when primary code is not accepted and confirm yearly physicals for reimbursement obligations.
Contact Outreach clients as needed to resolve appeals by obtaining appropriate medical record information, obtain missing diagnosis codes, and/or resolve invalid diagnosis codes
Minimum Qualifications to Fulfill Job Responsibilities:
Credentials: Knowledge of medical terminology, anatomy, physiology, disease process, ICD-10-CM, CPT, APCs, and/or other coding systems. Knowledge of encoders and coding guidelines. Knowledge of clinical classification systems, and reimbursement methodologies with the ability to identify, review, and interpret and assign correct ICD-10 codes.
Certificate program in coding or
associate degree in HIM or
a certificate with 1-3 years of healthcare experience (MA, HUC, Revenue Cycle)
No experience required if appropriate coursework has been completed
None if graduate of a program or associate degree, 1-3 years of healthcare experience (MA, HUC, Revenue Cycle) with a certification
otherwise, one of the following required:
Registered Health Information Administrator (RHIA),
Registered Health Information Technician (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist-Professional (CCS-P)
Certified Professional Coder (CPC)
Certified Outpatient Coder (COC)
Additional Requirements (must be obtained or completed within a period of time) :
Entry level position requires Either CCS, RHIA, RHIT credential. AHIMA or AAPC credential preferred.
Home Care Coding may require a Home Care Coding Specialist Certification (HCS-H)
NOTE: Current staff will be grandfathered into the position without credential. One of the above credentials must be obtained within 2 years. (by 6-1-2021)
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider netwo...rk and health insurer PreferredOne. In partnership with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.