CODING DOCUMENTATION SPECIALIST - UTILIZATION REVIEW

Presbyterian Healthcare Services - Albuquerque, NM (30+ days ago)3.6


About Us

Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of eight hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state’s largest private employer with approximately 11,000 employees.

Presbyterian’s story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.

We are part of New Mexico’s history – and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

Job Description

Type of Opportunity: Full Time

FTE: 1.000000

Exempt: Yes

Work Schedule: Days

Location: Rev Hugh Cooper Admin Center

Education:Essential:
  • Associate Degree
Credentials:Essential:
  • Certified Professional Coder
Other information:
Two to three years college level courses (predominantly in medical terminology, anatomy and physiology, and disease pathology) and three (3) years inpatient coding along with and/or auditing or compliance related experience OR five (5) years inpatient coding along with and/or auditing or compliance related experience. Must have any one of the following coding certifications at time of hire: CCS, CCA, CCS-P, CPC-A, CPC-H-A, CPC-H, CPC or RHIT/RHIA with achievement of coding credential within 12 months from date of hire. Excellent written and verbal communication skills. Detail and results oriented with the ability to maintain accurate detailed and organized records essential. Ability to work independently and make independent decisions. Working knowledge of medical terminology, ICD-9-CM, CPT-4, HCPCS, and DRG knowledge required. Achieve CCDS (Certified Clinical Documentation Specialist) within three (3) years employment as CDS

Summary:
This position is expected to assist medical staff providers with documentation in the medical record. Will be responsible to review physician documentation on a daily basis, keep track of patient diagnoses and procedure(s) to reflect the level of service provided. Will work independently on the patient care units and must be able to develop, schedule, and prioritize the workload to ensure all work is completed. Must be flexible to assist with coverage issues and a team player in consultation with other reviewers and HIM coders. Excellent communication skills are essential for daily interaction and collaboration with physicians and staff to ensure that clinical information in the medical record is present and accurate to support that the appropriate clinical severity is captured for the level of service rendered. This position may encounter resistance due to the perception that information is already adequately documented in the medical record. It requires experience and confidence to address all types of clinical documentation issues and regulatory requirements. The individual must be assertive and tactful to obtain medical staff cooperation. To maintain the compliance of policies and procedures within PHS; compliance to all external regulatory agency coding rules and regulations; conducting of internal audits for established areas within PHS conducive to clinical documentation and coding; training of PHS clinical documentation specialists along with physician and clinician personnel; research and interpret all regulatory agency regulations.

Benefits

Benefits are effective day-one (for .45 FTE and above) and include:

Competitive salaries

Full medical, dental and vision insurance

Flexible spending accounts (FSAs)

Free wellness programs

Paid time off (PTO)

Retirement plans, including matching employer contributions

Continuing education and career development opportunities

Life insurance and short/long term disability programs

About New Mexico

New Mexico’s unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque’s International Balloon Fiesta, Los Alamos’ nuclear scientists, Roswell’s visitors from outer space, and

Santa Fe’s artists, and you get an eclectic mix of people, places and experiences that make this state great.

Cities in New Mexico are continually ranked among the nation’s best places to work and live by Forbes magazine, Kiplinger’s Personal Finance, and other corporate and government relocation managers like Worldwide ERC.

New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it’s all available among our beautiful wonders of the west.

MT123

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.