Senior Outpatient Coder

Overview

At Houston Methodist, the Senior Outpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to day surgery and observation encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines.

Houston Methodist Standard

PATIENT AGE GROUP(S) AND POPULATION(S) SERVEDRefer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

• Provide personalized care and service by consistently demonstrating our I CARE values:
  • INTEGRITY: We are honest and ethical in all we say and do.
  • COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
  • ACCOUNTABILITY: We hold ourselves accountable for all our actions.
  • RESPECT: We treat every individual as a person of worth, dignity, and value.
  • EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.

• Practices the Caring and Serving Model

• Delivers personalized service using HM Service Standards

• Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)

• Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience

• Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job

• Actively supports the organization's vision, fulfills the mission and abides by the I CARE values

Responsibilities

PEOPLE ESSENTIAL FUNCTIONS

• Interacts and communicates effectively with members of the coding team and the appropriate stakeholders.

• Participates and provides good feedback during coding section meetings and coding education inservices as well as takes initiative to assist others and shares knowledge with the appropriate stakeholders.

SERVICE ESSENTIAL FUNCTIONS

• Responds promptly to internal and external customer requests. Responds promptly and appropriately to requests to code or review coded accounts for accuracy.

• Initiates queries with physicians to obtain or clarify diagnoses and/or procedures as appropriate, utilizing the established physician query process.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Responsible for assigning diagnostic and procedural codes to encounters of high complexity.

• Maintains and achieves departmental standards of coding quality by assigning accurate ICD-10-CM/ICD-10-PCS and CPT codes and APC assignment utilizing an electronic encoder application in accordance with hospital policy and regulatory body guidelines.

• Maintains and achieves departmental standards of abstracting quality by reviewing the discharge disposition entered by nursing and corrects if necessary in order to achieve the highest quality of entered data. Assigns and enters physician identification number and procedure date correctly in the medical record abstracting system.

• Reviews medical record documentation and abstracts data into the encoder and Electronic Health Record (EHR) to determine principal or final diagnosis, co-morbid conditions and complications, secondary conditions and procedures. Utilizes all tools/resources for accuracy.

• Complies with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official guidelines.

FINANCE ESSENTIAL FUNCTIONS

• Utilizes time effectively. Consistently codes and abstracts at or above departmental standards of productivity while ensuring accuracy of coding.

• Supports meeting organizational goal for Accounts Receivables (AR) associated with uncoded accounts.

• Maintains coding timeframes within established departmental standards by ensuring all work items assigned to the coding queues are processed in a timely manner.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Critically evaluates own performance, accepts constructive criticism, and looks for ways to improve.

• Displays initiative to improve relative to job function. Contributes ideas to help improve quality of coding data and abstracting data.

This job description is not intended to be all