Job SummaryAudits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents. Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies.All activities will be performed in support of the strategy, vision, and values of Phoebe. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA, and other regulations, as appropriate.General requirements Performs all job responsibilities in alignment with the core values, mission and vision of the organization Performs other duties as required and completes all job functions as per departmental policies and procedures Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs) Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time. Adheres to the hospital and departmental attendance and punctuality guidelinesWorking Conditions General environment\: Works in a well-lighted, air-conditioned area, with moderate noise levels. May be required to change from one task to another of different nature without loss of efficiency or composure. Periods of high stress and fluctuating workloads may occur. May be scheduled as needed including overtimeQualification:
Education Requirements 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) ;In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable.Experience Requirements 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records(Required) 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology(Required) 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies(Required)General Skills Organizational Skills,Communication Skills,Interpersonal Skills,Customer Relations,Mathematical,Analytical,Grammar / Spelling,Read / Comprehend Written Instructions,Follow Verbal Instructions,Basic Computer Skills,Microsoft Office Suite,General Clerical Skills.Physical Requirements Have near normal hearing; Hear alarms/telephone/tape recorder/normal speaking voice Have near normal vision\: Clarity of vision (both near and far), ability to distinguish colors Ability to perform repetitive tasks/motionPhysical Demands Occasionally within shift (1-33%) \: Standing,Walking,Bending/Stooping,Twist at waist,Pushing/Pulling,Reaching above shoulder. Continuously within shift (67-100%) \: Sitting.Certifications and Licensures Required Certifications/Licensures \: Certified Coding Specialist (CCS). Preferred Certifications/Licensures \: Registered Health Information Technician (RHIT),Registered Health Information Administrator (RHIA),AHIMA Approved ICD-10 Trainer.