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Job Description
Job Summary: This position is responsible for coordinating and facilitating the efficacy of ICD-9 and CPT coding in accordance with established policies, standards and procedures and the business objectives of the MBO. work includes: 1) working with department management to streamline delivery of HIM services; 2) serving as point-person for researching/resolving coding issues/problems; 3) conducting quality assurance reviews of coded accounts; 4) monitoring work flow and identifying staffing needs; 5) testing data integrity/flow between various systems; and 6) coordinating staff education to ensure compliance with internal operational standards and statutory/regulatory requirements. An incumbent also performs some advanced-level production coding work in order to maintain and enhance knowledge of current coding conventions and related regulations.Essential Duties:- Serves as point-person for adverse actions or questionable statistics that may be the result of coding errors/problems (e.g. claims rejected, reimbursement/billing issues, clinical effectiveness data, etc); troubleshoots assigned codes, coding documentation and related materials/supporting data to understand, identify and resolve issues of potentially serious dimension; follows up to ensure adjustments/corrections are made as necessary.
- Participates in the development and implementation of performance standards and coding-related procedures/guidelines that are designed to streamline/manage work flow/volume, enhance staff productivity and facilitate regulatory compliance; explains new and/or revised procedures, forms or other tools to coding staff.
- Performs quality assurance record reviews of coded accounts (random sampling) to ensure that optimal codes have been selected, that charts are consistently coded according to established coding guidelines and that data is correctly abstracted.
- Provides orientation and/or on-the-job training to new or lower-level coding staff with respect to regionally-approved guidelines and data capture via the abstract and encoder utility; reviews coded accounts to ensure optimal DRG has been selected, that charts are consistently coded according to established coding guidelines and that data is correctly abstracted.
- Reviews system-generated volume reports to monitor fluctuating staffing needs for the coding function; adjusts staffing levels to ensure coverage is appropriate to adequately address needs and facilitate achievement of performance standards and productivity targets.
- Monitors ongoing performance of coding staff to ensure that established standards for accuracy and productivity are being met in a satisfactory manner; identifies performance deficiencies and provides feedback to staff as necessary; identifies training needs and recommends educational opportunities; provides input into formal employee performance evaluations.
- Researches complex, unprecedented and/or ambiguous regulatory issues/questions relating to coding activities; contacts regulatory bodies to receive guidance with respect to the interpretation/application of guidelines; translates/interprets data to determine the into the proper code for specific situations as appropriate.
- Develops plans/scripts to perform user testing relating to the implementation/upgrade/maintenance of automated systems (e.g. Star, Quantim, ACIS or replacement systems) and/or changes in coding protocols/requirements in order to ensure the timely and accurate flow of data impacting the coding function; identifies issues and escalates to responsible party; follows up to ensure that timely and appropriate action to resolve problems has been made.
Job Requirements
Education:- High school diploma or equivalent required.
- Successful completion of an accredited health information management program preferred.
Experience:- Three years of progressively responsible medical coding work experience.
- One year of work experience in a 'lead' or supervisory capacity is preferred.
License/Certification:- Certification as a Registered Health Information Technician (R.H.I.T.), Registered Health Information Administrator (R.H.I.A.) or Clinical Coding Specialist (CCS).
Additional Responsibilities: Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times Adheres to and exhibits our core values:Reverence: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.Compassion: Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality. Maintains confidentiality and protects sensitive data at all times Adheres to organizational and department specific safety standards and guidelines Works collaboratively and supports efforts of team members Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community *hec*Catholic Health Initiatives and its organizations are Equal Opportunity Employers.
Shift: day
Status: Full Time
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