Description
US:NV:Carson City Health Information Management
Full Time Standard Office Hours
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Summary
The Hospital Medical Coding Analyst is responsible for accurately reviewing, analyzing, and coding inpatient and outpatient medical records to ensure proper reimbursement and compliance with regulatory requirements as well as process improvement in HIM. This role involves working with healthcare providers, clinical documentation teams, and revenue cycle staff to optimize coding accuracy, improve coding-related processes, and maintain compliance with industry standards such as ICD-10, CPT, and HCPCS coding systems.
Responsibilities
- Collaborates with the billing and revenue cycle teams to resolve claim denials, claim edits and rejections related to coding issues.
- Interprets and uses data to manage the operations of coding. Pursues and implements best practices using both internal and external resources. Formulates strategies and implements process improvement to sustain the overall efficiency and proficiency of coding.
- Maintains up-to-date knowledge of CMS guidelines, CIHQ, payor regulations, and industry best practices.
- Recommend improvements to HIM workflows and processes for better efficiency and accuracy.
- Serves as the outpatient/Inpatient-coding resource for Patient Financial Services and Patient Access. Interacts with Medical Staff, Quality, Case Management, Utilization Review, and Administration, and refers issues to HIM Manager.
- Investigates RAC and all other denials and provides input into the denial appeals process. Provides coding expertise for appeals and documentation requests from payors.
- Ensures proper application of coding modifiers and reimbursement methodologies.
- Identifies opportunities to optimize revenue capture and minimize claim denials due to coding errors.
- Conducts audits and reviews of medical records to validate coding accuracy and documentation completeness.
- Facilitates training of the qualified coders.
- Takes an active role in project or process implementation and monitors staff compliance and achievement of related goals. Assist with special projects as needed.
- Demonstrates knowledge of the Outpatient Prospective Payment System (OPPS) and MS- DRG assignment to ensure compliance.
- Assists the Health Information Manager in identifying and setting short- and long-term goals, program objectives and tasks to meet the mission and vision of the medical center. Monitors Productivity and accuracy of all coding staff for maintaining industry standards.
- Performs other related duties as assigned.
Qualifications
Required:
- Minimum of one of the following credentials:
- AHIMA RHIA
- AHIMA RHIT
- AHIMA CCS
- AAPC CPC or CIC
- Three (3) years of hospital coding experience.
Preferred:
- Associate’s degree in Health Information Technology.
- Bachelor’s degree in Health Information Administration.
- Any additional AAPC or AHIMA specialty credential above minimum requirement.
- Experience with Epic
- Strong knowledge of healthcare regulations, medical terminology, and coding systems (ICD-10, CPT, HCPCS).
- Excellent analytical, problem-solving, and organizational skills.
Top 5 Reasons to Live in Carson City, Nevada
- Live, work and play in one of the most beautiful regions in the world
- Enjoy an array of outdoor activities world class skiing, golf, camping, mountain biking, hiking, water skiing, kayaking, hunting and fishing
- Just next door is Beautiful Lake Tahoe
- We are minutes from Reno known as the ‘biggest little city in the world’ – Fine dining, nightlife, shopping and home to the University of Nevada Reno.
- Family friendly atmosphere with affordable housing & excellent school system
Our Benefits
- No State Income Tax
- Medical, Dental, Vision, FSA, Telehealth
- Paid Time Off, Mental Health, and Volunteer Days
- 100% Vested 401K & Roth with Company Contribution
- Tuition Reimbursement
- Referral Bonuses
- On Site Education & Certification Programs
- Base Wage Increases for Relevant Advanced Degrees
- Free Calm App Subscription
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