Review clinical documentation and pertinent diagnostic results as appropriate from the medical record to extract data and assign appropriate ICD-10 CM, ICD-10-PCS and CPT/HCPCS codes for billing, internal and external reporting, research and regulatory compliance. Hospital coding responsibilities include Ancillary, Emergency Department, Inpatient, Outpatient Surgery, Obstetrics, Infusion and Long Term Care (LTC).
Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
ESSENTIAL FUNCTIONS:
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHMIA) and adheres to official coding guidelines.
- Applies ICD-10CM, diagnosis and ICD-10-PCS procedure codes to accurately reflect patient visit documentation and identifies appropriate MS–DRG & APR-DRG’s that potentially impacts DRG leveling.
- Promotes and maintains cooperation and communication with physicians and all staff and clientele to ensure satisfactory results in reimbursement.
- Utilizes coding software and any other coding resources to code inpatient services, including procedures and diagnoses.
- Abstracts required data elements i.e. present on admission (POS), discharge status and as defined by management.
- Demonstrated ability to communicate coding issues to providers and submission of coding queries.
- Demonstrated ability to communicate coding issues with Clinical Documentation Improvement Specialist to assure specific conditions/procedures are documented and coded that directly impact hospital revenue.
- Acts as a resource to providers, other coders and hospital billing office on coding questions, issues and resolution of billing edits.
- Independently manages coding workload while applying complex coding principles in day-to-day job assignments.
- Performs other responsibilities as assigned, which are consistent with the goals and qualifications of this position.
- Abides by the Health Insurance Portability and Accountability privacy and security regulations regarding all aspects of Protected Health Information (PHI).
- Maintains a consistent coding quality accuracy rate that is equal to or greater than 95%.
- Meets productivity expectations according to patient classifications established by management.
MINIMUM KNOWLEDGE AND SKILLS REQUIRED:
- Demonstrated ability to apply inpatient coding principles.
- Computer skills with advanced knowledge of medical record systems and encoder applications
- Demonstrated ability to communicate effectively.
REQUIRED BEHAVIORAL SKILLS:
- Integrity:
- A personal presence which is characterized by a sense of honesty and the willingness to do the right thing.
- The ability to role model, inspire and motivate others to promote the philosophy, mission, vision, goals and values of Hutchinson Regional Healthcare System
- Compassion:
- A personal presence which is characterized by a sense of caring that is reflected in a high level of empathy and customer service with all that we come in contact.
- Ability to manage conflict, consider other points of view, and offer alternative solutions without jeopardizing overall project direction and the ability to manage customer expectations.
- Accountability:
- Demonstrated track record of ownership of situations, projects and issues.
- Able to work autonomously and have a high degree of flexibility to adapt to changing projects, priorities and work volumes.
- Respect:
- Demonstrated ability to collaborate with a diverse population.
- Treat all internal and external customers with a positive, proactive service orientation.
- Excellence:
- Strong communication and presentation skills with a proven ability to influence and lead teams to conclusion/decision making.
- Proven ability to think strategically but also must be able to lead day-to-day tactical processes.
- Demonstrated ability to manage and provide coaching and leadership on complex projects.
- Must be able to lead and/or facilitate process improvement.
MINIMUM EDUCATION AND EXPERIENCE REQUIRED:
- Advanced knowledge of Anatomy and Physiology, Medical Terminology, Pharmacology and ICD–10 CM/PCS coding
- Demonstrated ability to apply appropriate Complications and Co-Morbidity (CC) Conditions and Major complication/Co-Morbidity Conditions (MCC).
- Demonstrated knowledge of POA requirements, DRG, MS–DRG & APR-DRG’s.
- Knowledge of severity of illness and risk and mortality.
- Successful completion of Anatomy and Physiology, medical terminology, basic ICD-10-CM/PCS codingand CPT coding.
- 2 years experience working in Health Information Management, Medical office or healthcare environment.
PREFERRED EDUCATION AND EXPERIENCE:
- ICD-10 Education and Training
- Three years of hospital Inpatient coding experience
REQUIRED LICENSE/REGISTRATION/CERTIFICATION:
- Within 1 year of date of employment must become certified
PREFERRED LICENSE/REGISTRATION/CERTIFICATION:
- CCS, CCS-P,CPC, CPC-H, RHIT or RHIA
We offer competitive pay, a generous benefit package and a reason to be proud of what you do, every day.
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