HIM Coding Specialist II

Vail Health has become the world’s most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most beautiful views in the area, located centrally in Vail. Learn more about Vail Health here . Some roles may be based outside of our Colorado office (remote-only positions). Roles based outside of our primary office can sit in any of the following states: AZ, CO, CT, DC, FL, GA, ID, IL, KS, MA, MD, MI, MN, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA, and WI. Please only apply if you are able to live and work primarily in one of the states listed above. State locations and specifics are subject to change as our hiring requirements shift. This role is for professional coding queues. Candidates need to have experience with E/M leveling with strong understanding of E/M guidelines, including Medical Decision Making (MDM) and time-based coding with ability to accurately assign diagnosis and procedure codes for professional services. Ideal candidates will have experience with oncology and radiation coding experience or OB/GYN experience. Epic experience is a plus. About the opportunity: In accordance with Governmental, third party payer, and outpatient rules and regulations, accurately assigns and sequences ICD-10-CM diagnosis, CPT procedural codes and HCPCS codes to ProFee inpatient and outpatient records for use in reimbursement and data collection What you will do: Understand and read patient records. Verify patient information to identify any documentation vs. report discrepancies and to ensure codes and other abstracted data are accurately applied to appropriate patient’s account/encounter. Codes outpatient professional encounters. Apply codes to conditions and procedures documented in and abstracts data from medical records to provide information for financial reimbursement and data collection, converts interpreted data into appropriate code numbers. Assess documentation and/or queries physician for additional information when indicated to clarify or provide specificity to a diagnosis, symptom, or reason for an outpatient service. Proficient in accessing and understanding local and national coverage determinations (LCDs/NCDs). Recognize and reports unusual circumstances and/or information with possible risk factors to appropriate risk management and department leadership and reports problems, errors, and discrepancies in dictation and patient records to department leadership. While reviewing the record for coding purposes, serves as quality reviewer of scanned documents. Identifies mis-scans and poorly scanned documents and reports them to department leadership. Meet coding quality and quantity expectations. Strives to maintain coding within one business day of the account populating the coding queue. Accommodate a varied work schedule including rotating weekend coverage to achieve a three-day-out currency. Collaborate with others in the organization including the Quality Department, Medical Staff, other clinicians, and physician office staffs; and with Patient Financial Services to ensure the codes submitted for claims are supported by the documentation in the record. When querying clinical staff, uses appropriate querying techniques to avoid leading the clinician and follows up to ensure queried accounts are dropped within 10 days of the query. As needed, involves department leadership or Coding Supervisor. Promptly address edits and questions from Patient Financial Services within one business day. May participate in various committees as appropriate and prepare and provide provider in-services. Attend all required in-services and coder meetings. Identify and attend training and educational programs conducive to professional growth. Utilize current literature and workshops attended to the benefit of the organization. New ideas, policies, regulations, and philosophies are adapted to curr…