Medical Coder I- Outpatient- Same Day Surgical, Observation

General Summary of Position
Codes and abstracts primarily Emergency Department, Observation, and other outpatient records using ICD-10-CM, and other applicable patient classification schemes. May also perform beginning level of Ambulatory Surgery.

Minimum Qualifications
Education

• Performs other duties as assigned.
• CPC (Certified Professional Coder), CCA (Certified Coding Associate) or other coding certification credentials within 1 Year Required and
• Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.
• Courses in Medical Terminology, Anatomy & Physiology, ICD-CM Required and
• Meets established Productivity standards as defined by policies.
• Abstracts and ensures accuracy of diagnoses, procedure, patient demographics, and other required data elements.
• Resolves all quality reviews timely (e.g. Medical necessity reviews; Coding Quality assurance reviews; external vendor reviews).
• Basic computer skills required.
• Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic, procedural codes, and appropriate modifiers using standard guidelines and automated encoding software maintaining departmental accuracy standards.
• Verbal and written communication skills.
• Coding experience and experience with clinical information systems (3M grouper, electronic medical records, computer assisted coding) Preferred
• Associate's degree in coding related Preferred or
• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
• Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
• Exhibits knowledge of the 3M system and other work-related equipment.
• More career opportunities closer to home—as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
• Equivalent Required and
• Bachelor's degree in coding related Preferred and
• RHIT (Registered Health Information Technician) and RHIA (Registered Health Information Administrator) Preferred
• Strong emphasis on teamwork—our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
• Participates in multi-disciplinary quality and service improvement teams.
• CPT-4 Preferred
• High School Diploma or GED Required or
• Comprehensive total rewards package—including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
• Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.
• Adhere to all compliance regulations and maintains annual compliance education.
• Meets established Quality standards as defined by policies.