Coder II - Outpatient | PRN at Abarca Health

Sioux Falls, South Dakota, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Part TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Certified Coding Associate (CCA) - AHIMA within 180 days, or Certified Coding Specialist - Physician-based (CCS-P) - AHIMA within 180 days, or Certified Coding Specialist (CCS) - AHIMA within 180 days, or Certified Outpatient Coder (COC) - AAPC within 180 days, or Certified Professional Coder (CPC) - AAPC within 180 days, or Registered Health Information Administrator (RHIA) - AHIMA within 180 days, or Registered Health Information Technician (RHIT) - AHIMA within 180 days
Visual acuity adequate to perform position duties
Ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds
Preferred: Associate's in Health Information Administration or Health Information Technology; 1-3 years coding experience
Commitment to Avera’s mission, vision, core values, and social principles; promote values of compassion, hospitality, and stewardship; uphold standards of Communication, Attitude, Responsiveness

Responsibilities

Review all aspects of patient's clinical documentation to assign appropriate sequence of ICD-10-CM, CPT, and HCPCS diagnosis and procedure codes for outpatient charts across Avera's facilities
Determine appropriate APC/EAPC and/or medical coding for outpatient patient types including ER, ancillaries, imaging, lab, PT, OT, SP, and/or dialysis
Maintain in-depth understanding of ICD-10-CM, CPT, and HCPCS codes and update knowledge through research or education
Serve as subject matter expert for other health professionals on coding topics as needed
Query physicians and clinical documentation staff to ensure full capture of the clinical record
Assist with or lead communication between health information management, billing, and providers
Maintain personal quality and production statistics according to service line standards for Coder II
Perform timely and accurate assignment of codes, abstracting, reporting, and editing functions independently to meet quality and production goals

Skills

ICD-10-CM

CPT

HCPCS

Medical Coding

APC

EAPC

Clinical Documentation

Code Abstracting

Physician Querying

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

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