Him Coder III

Cottage Health • Goleta, CA

1d

About The Position

Codes and abstracts inpatient and outpatient conditions, diseases, reason for encounters, social determinants of health and PCS/CPT procedures to report accurate administrative and clinical data, utilizing approved coding guidelines as set forth in Official Coding Guidelines, ICD Book, Coding Clinic for ICD-CM/PCS, AHA Coding Clinic for HCPCS and CPT Book. Assigns appropriate DRG/APC prospective payment systems and classifications, to reflect the appropriate severity and illness for inpatient and specialty cardiac, neurology, and vascular outpatient encounters. Collaborates closely with clinicians and CDI staff, not excluding inpatient rehab coordinators to obtain appropriate documentation, as needed. Assists with internal coding audit and training activities Responsibilities This is not an exhaustive statement of duties, responsibilities, or requirements. Employees will be required to perform any job, with related instruction given by their supervisor, subject to reasonable accommodation. Codes and abstracts reportable diseases, procedures and state regulatory data elements from the medical record according to ICD-CM/PCS and CPT classification systems, state and national regulatory agencies respectively, utilizing only HIPAA approved coding references. (40%) Validates coding to assure proper DRG/SOI/ROM/APC assignment. (25%) Communicates with physicians, CDI and IP Rehab Coordinators concerning incomplete documentation and clarification of diagnoses/procedures utilizing appropriate AHIMA & facility query process. Communicates with Patient Financial Services regarding denials, appeals and rejections. (10%) Participates in quality improvement activities by identifying specific cases and pertinent data as requested. Completes and monitors follow up activities, complete documentation, MD Query responses, claim and DNB edits, daily. Participates and keeps abreast of coding education changes and participates in educational growth opportunities as well as maintain CEUs for certification. (10%) Assists with internal coding audit and training activities. (5%) Participates in the coder training program by providing assistance to the Coder I and Coder II staff members. (5%) Participates in quality improvement activities by identifying specific cases and pertinent data as requested. (5%) Communicates with physicians concerning incomplete documentation and clarification of diagnoses/procedures utilizing appropriate facility query process. (5%) Qualifications All job qualifications listed indicate the minimum level necessary to perform this job proficiently. LEVEL OF EDUCATION Minimum: Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-CM/PCS and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process Preferred: Associates Degree Health Information Management

Requirements

• Formalized education that provides knowledge and experience in the following areas: 1) Assigning ICD-CM/PCS and CPT coding classifications in an acute care setting; 2) UHDDS reporting requirements; 3) Medical terminology, anatomy, chemistry, pharmacology, physiology, and disease process
• CCS
• 5 Years of related work experience
• This position provides support to other coding staff and works with members of the Medical Staff and must be able to diplomatically deal with issues that arise to clarify or obtain information necessary for accurate coding.
• This position requires high level communication skills to be able to explain documentation variances and complicated coding requirements.
• Ability to work with minimum supervision and interact professionally with physicians and other hospital personnel.
• This position requires the following abilities: critical thinking skills to identify and locate information maintained in various mediums and locations, ability to read, understand, and reiterate clinical information to apply regulatory and coding standards for a multitude of acute care settings.

Nice To Haves

• Associates Degree Health Information Management
• CCS and RHIT or RHIA
• 7 Years of related work experience

Responsibilities

• Codes and abstracts reportable diseases, procedures and state regulatory data elements from the medical record according to ICD-CM/PCS and CPT classification systems, state and national regulatory agencies respectively, utilizing only HIPAA approved coding references. (40%)
• Validates coding to assure proper DRG/SOI/ROM/APC assignment. (25%)
• Communicates with physicians, CDI and IP Rehab Coordinators concerning incomplete documentation and clarification of diagnoses/procedures utilizing appropriate AHIMA & facility query process. Communicates with Patient Financial Services regarding denials, appeals and rejections. (10%)
• Participates in quality improvement activities by identifying specific cases and pertinent data as requested. Completes and monitors follow up activities, complete documentation, MD Query responses, claim and DNB edits, daily. Participates and keeps abreast of coding education changes and participates in educational growth opportunities as well as maintain CEUs for certification. (10%)
• Assists with internal coding audit and training activities. (5%)
• Participates in the coder training program by providing assistance to the Coder I and Coder II staff members. (5%)
• Participates in quality improvement activities by identifying specific cases and pertinent data as requested. (5%)
• Communicates with physicians concerning incomplete documentation and clarification of diagnoses/procedures utilizing appropriate facility query process. (5%)

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree