Schedule Weekly Hours:

The Coding Specialist - Ambulatory Services scope of work includes care provided in a professional clinic, outpatient and inpatient hospital setting, nursing home or home setting. The Coding Specialist - Ambulatory Services will apply their knowledge of chart auditing including all CPT, HCPCS or ICD 10-CM coding guidelines consistent with standard coding practices to ensure complete and compliant code assignment. The Coding Specialist - Ambulatory Services is responsible for reviewing all available documentation for each patient's clinic or hospital encounter and assigning appropriate code(s) for each service performed. Codes assigned will accurately represent the medical necessity for services provided. The Coding Specialist - Ambulatory Services will utilize standard query and clarification processes to assure consistency between documentation, charges and assigned codes. Adheres to the AHIMA Standards of Ethical Coding and AAPC Code of Ethics and the official coding rules and guidelines. Occasional travel to Gundersen Health System facilities will be required.

Major Responsibilities:

1. Reviews and audits patient medical records and applies knowledge of medical practice, coding guidelines, anatomy and physiology, pathophysiology, and pharmacology to select appropriate diagnostic and procedural codes for purposes of billing, research, planning and quality improvement for professional services provided in the clinic outpatient setting, hospital inpatient/outpatient and ancillary services, encounters or hospital facility services for, emergency services and urgent care.

2. Adheres to the ICD-10-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the Cooperating Parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association, the AHIMA Standards of Ethical Coding and AAPC Code of Ethics and any other official coding rules and regulations applicable to the work they are performing.

3.Assesses the completeness and consistency of documentation in support of the medical necessity for the services provided and code assignment. If incomplete or conflicting clinical documentation is identified, utilize standard query processes to contact providers for additional information for clarification and additional documentation prior to code assignment.

4.Assists with coding inquiries for internal and external customers.

5.Assists with internal coding audits as requested.

6.Takes the initiative to develop and build coding competency by staying abreast of advances in medical practice and technology, coding guidelines and regulations. Obtains continuing education and maintains current certification through the applicable professional society.

7. Assists with staff/student training, including job shadow applicants.

8.Performs other job-related responsibilities as requested.

Education and Learning:

REQUIRED

High School Diploma or equivalency

DESIRED

Associate degree in Health Information Management or Medical Coding Certificate

Work Experience:

REQUIRED

1 year experience in a healthcare facility, health care business office or equivalent education.

Applicants within 3 months of completion of RHIT or RHIA program meet this requirement

DESIRED

1 year coding experience.

License and Certifications:

REQUIRED

Certified Professional Coder (CPC) orCertified Professional Coder - Apprentice (CPC-A) or

Certified Coding Associate (CCA) or

Certified Outpatient Coder (COC) or

Certified Coding Specialist (CCS) or

Certified Coding Specialist-Physician Based (CCS-P)

OR

Registered Health Information Administrator (RHIA)* or

Registered Health Information Technician (RHIT)*

*May obtain within 12 months of hire if applicant is within last 3 months of accredited program.

Age Specific Population Served:

Nonage Specific (N/A)

OSHA Category:

Category III - No employees in this job title have a reasonably anticipated risk of occupational exposure to blood and/or other potentially infectious materials.

Environmental Conditions:

Not substantially exposed to adverse environmental conditions (as in typical office or administrative work).

Physical Requirements/Demands Of The Position:

Sitting Continually (67-100% or 8 hours)

Repetitive Actions - Pinch Forces Frequently (34-66% or 5.5 hours)

Repetitive Actions - Fine Manipulation Continually (67-100% or 8 hours)

Lifting - Other Occasionally (6-33% or 3 hours) Number of lbs 0-25

If you need assistance with any portion of the application or have questions about the position, please contact or call 608-775-0267

Equal Opportunity Employer