POSITION SUMMARY:
Provide administrative support to management and staff. Work Physician Query Listing. Submit pendingcodingquery reports to administrationon a daily basis.Work department deficiency reports.Review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM codes for billing, internal and external reporting, research, and regulatory compliance. Accurately code outpatient conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors.Utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and procedures.Reviews documentation to verify and, when necessary, correct the patient disposition upon discharge. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
POSITION EDUCATION/ QUALIFICATIONS:
- CCS-P, CCA, CPC, COC, CIRCC, CTR, CIC, CPC-P, CPC-H, Specialty, or Medical coding certification program preferred
- Obtainone of the above certificationsbyone year after hire date
- Organizational skills is necessary
- Good written and verbal communication skills required.
- Ability to read, write and speak English required
- Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians
JOB KNOWLEDGE/EXPERIENCE:
- Experience and/or training in medical coding, medical terminology and anatomy and physiology required.
- Requires reasoning ability and good independent judgment
- Ability to perform productive research quickly
- Must have an understanding of laws and ethics related to health insurance, medical billing and Health insurance Portability and Accountability Act (HIPPA)
- Computer and coding software experience required, 3M encoder preferred
- Requires good communication and organizational skills.
- Requires reasoning ability and good independent judgment.
- Requires working with frequent interruptions.
POSITIONRESPONSIBILITES:
- Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
- Must be able to multitask
- Maintains confidentiality and safeguards all patient related information.
- Able to perform the necessary functions on the facility computer system
- Manages the codingquery log
- Contact and follow up with physicians regarding pending coding queries
- Incollaboration with HIM, enforceClinical Documentation Improvement Policy 2: Physician Response to Queries[Policy #: LD-3036]
- Communicates with Coding Manager to solve problems and to clarify coding issues
- Accurately Codes outpatient procedures according to most current ICD-10-CM, CPT and APC guidelines
- Utilizes computerized 3M Coding Software
- Ability to code outpatient record types such as: EMR, Radiology, Series, RMF Clinics,ect…
- Ability to accurately attach HCPCS Level I and Level II modifiers for billing purposes
- Must meet volume requirements of 120-150 accounts coded daily
- Meets quality standards of having 95% of charts coded accurately
- Must take initiative in researching to further his/her own knowledge in coding
- Must research 3M Coding references for final coding
- Must be able to validate CPT and procedure description
- Must be able to identify medical abbreviations, terms and their meanings
- Maintains a good working relationship within the department, other departments, and medical staff
- Meets productivity standards set forth by the coding manager
- Assist the business office with clearing reimbursement and denial issues
- ClearsAeosin a timely manner
- SatisfyCEUhour requirementsaccording to certification requirements
- Utilizes coding references
- Adheres to the Health Information Management Policies and Procedures for Coding
- Adheres to the Coding Compliance Plan
- Follows the AHIMA Standards of Ethical Coding
- Performs other duties as assigned
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