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GENERAL SUMMARY OF POSITION: 

Under the general supervision of the Medical Coding Supervisor or designee, the Outpatient Medical Coding Specialist is responsible for assigning diagnosis codes for outpatient services to be used for federal claiming purposes. The Specialist will code and abstract outpatient medical records using the standardized coding system, to include identifying and classifying disease and procedure codes.

MAJOR RESPONSIBILITIES:

• Performs medical coding for current outpatient clinic and related ancillary department services, including medical, behavioral health, intensive care, surgical and other specialty services. 
• Assigns appropriate CPT-4 (or its successor) and ICD-9 (or its successor) procedure and diagnosis codes to all outpatient and related ancillary services. 
• Assigns appropriate concurrent CPT or ICD codes for ancillary services provided in outpatient or clinic visits as well as any specialized services provided in outpatient or inpatient settings. 
• Researches, analyzes, and re-codes national medical necessity (NCD) denials and local medical review (LMRP) denials for Medicare patients as appropriate for resubmission.
• Abstracts and enters all codes and required demographic information into the appropriate computer systems and forms.
• Reviews the CPT code assignment for “Other” procedures noted on Outpatient Encounter Forms.
• Participates in professional training as necessary including ICD-10 training and implementation.
• Maintains productivity/performance levels consistent with industry standards.
• Fosters compliance with state and federal rules and regulations.
• Works independently and as a team member and leader.
• Preserves confidential, protected health and personally identifiable information and files.
• Performs other duties as assigned.

REQUIRED QUALIFICATIONS:

• Associates Degree in Medical Terminology or a related field; or equivalent relevant experience
• 1-2 years of medical coding experience
• Knowledge of healthcare and medical terminology, including ICD-9 and CPT-4 codes
• High degree of organization and strong attention to detail
• Ability to communicate and problem solve effectively
• Proficient in computer skills and Microsoft Office
• Must maintain current knowledge of coding and billing practices through reading of newsletters, publications and attendance at seminars.

PREFERRED QUALIFICATIONS:

• Completion of or working towards credentials of Certified Professional Coder (CPC)
• Knowledge of state and federal rules and regulations related to health care finance
• Ability to plan, prioritize and schedule multiple work tasks
• Experience with MEDITECH Health Information System

This position is located within the Lemuel Shattuck Hospital in the Jamaica Plain section of Boston, Massachusetts.