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The Coding Specialist I will be responsible applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters ambulatory/ provider based clinics.
GENERAL DUTIES
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Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers.
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Validates charges by comparing charges with health record documentation as necessary.
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Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
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Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems.
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Tracks issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion.
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Consistently meets coding quality and productivity standards established by coding department.
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Adheres to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information.
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Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
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Performs other duties as assigned by leadership.
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Maintains working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
EDUCATION/EXPERIENCE QUALIFICATIONS
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HS Diploma and 2 years of experience, or
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Associate’s degree in Coding (or similar field)—no experience required
LICENSES AND CERTIFICATIONS
It is preferred that the coder have one or more of the following certifications:
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Certified Professional Coder from the American Academy of Professional Coders (AAPC)
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Certified Outpatient Coder from the American Academy of Professional Coders (AAPC)
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Certified Inpatient Coder from the American Academy of Professional Coders (AAPC)
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Certified Professional Coder – Payer from the American Academy of Professional Coders (AAPC)
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Certified Risk Adjustment Coder from the American Academy of Professional Coders (AAPC)
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Certified Coding Associate from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA
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Preferred: Registered Health Information Technician from the Commission on Certification for Health Informatics and Information Management (CCHIIM)
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Certified Coding Specialist from the Commission on Certification for Health Informatics and Information Management (CCHIIM)
KNOWLEDGE, SKILLS, AND ABILITIES
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Working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping and components of charge description master for charging functions and understanding when to use the appropriate modifiers.
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Must possess knowledge of third-party reimbursement regulations and billing practices.
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Experience utilizing encoding/grouping software.
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Ability to use standard desktop and windows-based computer system, including basic understanding of email, internet, and computer navigation.
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High ethical standards.
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Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines.
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Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters.
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Knowledge of hospital and professional coding including provider-based billing.
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Knowledge of documentation regulations of Joint Commission and CMS.
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Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices.
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Experience in assisting and identifying learning needs as well as providing training to coding staff.
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Strong analytical abilities and problem-solving skills.
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Excellent oral, written and interpersonal communication skills.
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Ability to organize and set priorities to ensure objectives are met in a timely manner.
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Ability to adapt to change and handle challenges proactively and with pose.
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Ability to effectively collaborate with physicians and managerial staff at all levels.
WORK SHIFT:
Days (United States of America)
LCMC Health is a community.
Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary
Your extras
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Deliver healthcare with heart.
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Give people a reason to smile.
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Put a little love in your work.
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Be honest and real, but with compassion.
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Bring some lagniappe into everything you do.
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Forget one-size-fits-all, think one-of-a-kind care.
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See opportunities, not problems – it’s all about perspective.
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Cheerlead ideas, differences, and each other.
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Love what makes you, you - because we do
You are welcome here.
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
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