Coder Job Summary: This position assigns diagnosis and procedures codes to patient accounts to ensure accurate and timely claims to be submitted to payers for reimbursement. This position needs to be comfortable coding inpatient, observation, outpatient surgery, wound care, and Emergency Department.
Coder Shift Availability:
Coder Benefits:
Coder Essential Accountabilities:
Completes inpatient, observation, outpatient surgery, clinic and Emergency Department coding functions utilizing approved system workflow applications for coding, abstracting, and financial billing.
Demonstrates the ability to achieve accurate, complete and consistent selection of principle and relevant secondary diagnosis and procedures; identifies complications/co-morbid conditions; and verifies discharge disposition codes. Knowledge of CMS-DRGs, Present on Admission indicators, Hospital Acquired Conditions, RHC requirements, CMS-CMGs and other quality indicators that impact reimbursement and public reporting.
Queries physicians for clarification of documentation as directed by Coding Guidelines, Coding Clinic, CPT Assistant and facility specific guidelines. Ability to determine observation times and adjust for carve outs.
Responds to billing edit queries from Patient Financial Services within departmental guidelines.
Follows American Hospital Association (AHA) Coding Guidelines and other regulatory agency directives for ICD, CPT, and HCPCS II coding.
Maintains current knowledge of coding issues by reading official coding guidelines such as AHA Coding Clinic, American Medical Association (AMA) CPT Assistant, WPS and CMS medical necessity regulations.
Meets productivity and accuracy requirements consistently per HIM policy.
Maintains professional certification as mandated by professional organizations (AHIMA, AAPC).
Assists HIM management in orientation and training of new staff and contract coders, as required. Serves as resource and subject matter expert to other coding staff and hospital staff.
Attend continuing education seminars via remote or on site as scheduled to maintain credentialing.
May perform other duties as assigned.
Coder Organizational Accountabilities:
Completion of HealthStream's education by designated due dates.
Attends required staff/department/organization’s meetings.
Demonstrates strong, clear communication skills.
Upholds the C.A.R.E. Values of McPherson Center for Health
Exhibits professionalism at all times.
Maintains confidentiality as required by HIPPA regulations.
Participates in the professional development of self and team members.
Coder Qualifications:
Education:
Certifications:
Experience:
Skills:
Highly knowledgeable of clinical information such as disease process, pathology, pharmacology, anatomy and physiology, and procedural and surgical intervention.
Knowledge of computerized encoder and abstracting systems as well as coding guidelines.
Essential knowledge of ICD coding conventions, CPT coding conventions and DRG/APC encoder applications.
Mastery of coding guidelines for sequencing and selection
Coder Working Conditions:
Hazardous Working Conditions:
Environmental Surroundings:
Physical Working Conditions:
We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability, status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
