Description

SUMMARY:

Ensures proper assignment of diagnosis and procedure codes, along with validating and adjusting charges according to the services the patient received. Works collaboratively with Clinical Documentation Improvement personnel to ensure coding is clinically supported. Participates in the identification and resolution of discrepancies in documentation; assists in training as necessary. Maintains a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Compliance Accountability Program, 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. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior.

Requirements

REQUIREMENTS:

      Associate’s Degree in Health Information Management or related field.

      Two (2) years of documented experience in ICD-10-CM and ICD-10-PCS coding and DRG reimbursement.

      Certification through AHIMA in Registered Health Information (RHIA, RHIT) or as a Certified Coding Specialist (CCS); or Certification through AAPC as a Coding Specialist (CIC).

      Demonstrated knowledge of reimbursement methodology pertaining to MS-DRG’s, APR-DRG’s, and APC’s.

      Ability to properly sequence ICD-10 codes based on coding guidelines and coding clinics.  Proficient on identifying POA, SOI, and ROM indicators for Inpatient records as well as HAC’s and PSI’s to ensure accurate hospital reimbursement.

      Knowledge of the required content and claim completion guidelines of the UB04.

      Possesses a strong foundation in coding conventions, instructions, Official Guidelines for Coding and Reporting as well as Coding Clinics.

      Demonstrated ability to function in a 100% virtual environment working independently while maintaining efficiency, compliance, and coding quality standards.

      Enhances coding knowledge and skills with continuing education activities and by reviewing pertinent literature.

      Knowledge of professional coding practices.

      Ability to communicate effectively in oral and written modes.

      Ability to interact successfully and maintain harmonious relationships with physicians and Medical Center personnel.