Description
ESSENTIAL FUNCTIONS:
- Assign appropriate diagnosis and procedure codes utilizing ICD 10-CM, CPT, and HCPCS according to the Centers for Medicare & Medicaid Services (CMS) requirements for hospital billing.
- Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
- Must be familiar with Ambulatory Payment Categories (APCs, the Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) guidelines, Local and National Coverage Decisions, and other medical necessity/compliance guidelines for billing and coding.
- May verify, edit and/or enter charges based on documentation or payer/billing.
- Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the coding area.
- Follow coding workflows for service type to include addressing compliance reviews.
- Submit physician queries when clarification of documentation is needed.
- Facilitate a positive working relationship with physicians, nurses, medical staff, and hospital employees to ensure that all work-related encounters are productive.
- May assist in training and reviewing the work of other coders for accuracy and efficiency.
- Make recommendations to the supervisor, and implement and monitor results as appropriate in support of the overall goals of the department.
- Seek advice and guidance as needed to ensure proper understanding.
- Assist others with responsibilities and adjusts work schedule to meet department needs.
- Use independent discretion/decision-making while effectively working remotely.
- Attend required educational webinars, conference calls, and other coding seminars, and participate in all formal and informal coding discussions.
- Maintain coding education hours and renew annual coding credentials as applicable.
- Complete all assigned compliance courses within the designated period.
- Conform to AHIMA’s Code of Ethics and Standards of Ethical Coding, LifePoint Attendance Policy, and ensure patient/employee privacy and dignity by maintaining confidentiality with no infractions.
- Other related job tasks or responsibilities as assigned.
- Additional Information: The position serves internal co-workers and external customers, clients, and contractors.
- Access to and/or work with sensitive and/or confidential information.
KNOWLEDGE, SKILLS & ABILITIES:
- The requirements below represent the required knowledge, skills, and/or abilities.
Qualifications
- Certifications: Certified Coding Associate (CCA), Certified Professional C coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) preferred.
- Coder must be able to code all OP chart types: Amb Surgery, Observation, Ancillary, Wound Care and ED.
- Client trains on each system and site.
- Systems: Meditech