Hospital Coder
Albany, NY jobs
Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements.
Essential Duties and Responsibilities
* Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM-CPT4.
* Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines.
* Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
* Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
* Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
* Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim.
* Comply with comprehensive internal coding policies and procedures that are consistent with requirements.
* Attends coding meetings and roundtable sessions.
*
* Focused with no distractions while working and participating in meetings.
* Ensures camera on while attending Teams calls.
* Assists with organizing the shared drive for the medical coding department.
* Other duties as assigned by manager.
Qualifications
* High School Diploma/G.E.D. - required
* Prior experience in hospital medical coding - preferred
* Prior experience with 3M 360 and EPIC system - preferred
* Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency)
* Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency)
* Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency)
* Excellent written and verbal communication skills. (High proficiency)
* Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency)
* Detail-oriented and efficient while maintaining productivity.
* Coding certification / credential through AHIMA or AAPC and be in good standing. - required
Equivalent combination of relevant education and experience may be substituted as appropriate.
Physical Demands
* Standing - Occasionally
* Walking - Occasionally
* Sitting - Constantly
* Lifting - Rarely
* Carrying - Rarely
* Pushing - Rarely
* Pulling - Rarely
* Climbing - Rarely
* Balancing - Rarely
* Stooping - Rarely
* Kneeling - Rarely
* Crouching - Rarely
* Crawling - Rarely
* Reaching - Rarely
* Handling - Occasionally
* Grasping - Occasionally
* Feeling - Rarely
* Talking - Frequently
* Hearing - Frequently
* Repetitive Motions - Frequently
* Eye/Hand/Foot Coordination - Frequently
Working Conditions
* Extreme cold - Rarely
* Extreme heat - Rarely
* Humidity - Rarely
* Wet - Rarely
* Noise - Occasionally
* Hazards - Rarely
* Temperature Change - Rarely
* Atmospheric Conditions - Rarely
* Vibration - Rarely
Thank you for your interest in Albany Medical Center!
Albany Medical Center is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Thank you for your interest in Albany Medical Center!
Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Auto-ApplyMedical Coding Specialist-Hybrid Position
Washington, DC jobs
INTRODUCTION
Under the supervision of the Medical Billing Coding Manager, the coding specialist is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding specialist also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
DUTIES AND RESPONSIBILITIES
Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Supports the Senior Medical Billing and Coding Specialist to respond to audit findings and make applicable coding additions or corrections.
Registers and analyzes claims in the EMR system, including insurance verification and charge entry. Tracks and requests outstanding claims for assigned departments/facilities.
Reviews Medicare Local Coverage Determination (LCDs) and Medicare bulletin updates.
Utilizes the EMR system to run required daily/monthly/quarterly reports on claims entered.
Accepts assignments from management and maintain open communication with their manager to resolve quality and production issues.
Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third-party reimbursement agencies and special screening criteria.
Complies with the rules and regulations of Medicare billing including (but not limited to) incident to, teaching situations, shared visits, consultations, and global surgery.
Efficiently and accurately processes all types of claims utilizing broad based product or system knowledge to ensure timely payments are generated.
Maintains strict confidentiality regarding confidential conversations, documents, and files.
Supports the Senior Medical Billing and Coding Specialist to facilitates coding orientation for new providers.
Ability to read and abstract physician office notes and procedure notes to apply correct ICD-10-CM, CPT, HCPCS Level II and modifier coding assignments. Perform audits when necessary.
Performs other duties as assigned.
QUALIFICATIONS
High School diploma or GED required/associate's degree preferred.
Minimum of 5 years' coding experience using ICD-10-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions.
Coding certification is required through AAPC or AHIMA
KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION
Complete knowledge and understanding of PM and EMR workflows.
Must demonstrate ability to work independently with minimum supervision in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs.
Advanced knowledge of medical codes involving selections of most accurate and description code using the extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
Excellent oral, written, and telephone communication.
Working familiarity with the rules and regulation pertaining to the government/private/FQHC guidelines.
Ability to prioritize and manage multiple task with efficiency in dealing with multiple facilities.
Ability to handle a large volume of project receiving and researching claims.
Excellent computer skills, including Excel, Microsoft Word, etc.
SUPERVISORY CONTROLS
This position reports directly to the Coding Manager.
GUIDELINES
This position abides by all rules and regulations set forth by applicable licensing and regulatory bodies, as well as UHC policies and procedures.
PERSONAL CONTACTS
This position has primary contact with the clients and employees of Unity Health Care.
PHYSICAL DEMANDS
Refer to attached ADA requirements for the position.
WORK ENVIRONMENT
Refer to attached ADA requirements for the position.
OTHER SIGNIFICANT FACTS
Hours may include some evenings and/or Saturday work. While every effort is made to assign staff to one clinic site regularly, Unity may change the assigned clinic and/or site temporarily or permanently, depending upon the need.
RISKS
The position works involves everyday risk and discomforts, which require normal safety pre-caution typical of such places as offices, meetings, training room and other UHC health Care Sites. The work area is adequately lit, heated and ventilated. The position requires contact with staff at all levels throughout the organization. There are also external organization relationships that may be a part of the work of this individual. All medical services shall be provided according to medical accepted community standards of care. Shall provide evidence of recent (within the past twelve (12) months) health assessment that includes a PPD and/or chest x-ray results. Shall provide evidence of vaccination for Hepatitis A & B.
The statements contained herein describe the scope of the responsibility and essential functions of this position, but should not be considered to be an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other areas to cover absences or relief to equalize peak work periods or otherwise balance the workload.
Auto-ApplyHospital Coder
New Scotland, NY jobs
Department/Unit:
Health Information Services
Work Shift:
Day (United States of America)
Salary Range:
$55,895.80 - $83,843.71The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements.
Essential Duties and Responsibilities
Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines.
Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines.
Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim.
Comply with comprehensive internal coding policies and procedures that are consistent with requirements.
Attends coding meetings and roundtable sessions.
Participates in daily huddles and LEAN problem-solving activities.
Focused with no distractions while working and participating in meetings.
Ensures camera on while attending Teams calls.
Assists with organizing the shared drive for the medical coding department.
Other duties as assigned by manager.
Qualifications
High School Diploma/G.E.D. - required
Prior experience in hospital medical coding - preferred
Prior experience with 3M 360 and EPIC system - preferred
Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency)
Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency)
Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency)
Excellent written and verbal communication skills. (High proficiency)
Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency)
Detail-oriented and efficient while maintaining productivity.
Coding certification / credential through AHIMA or AAPC and be in good standing. - required
Equivalent combination of relevant education and experience may be substituted as appropriate.
Physical Demands
Standing - Occasionally
Walking - Occasionally
Sitting - Constantly
Lifting - Rarely
Carrying - Rarely
Pushing - Rarely
Pulling - Rarely
Climbing - Rarely
Balancing - Rarely
Stooping - Rarely
Kneeling - Rarely
Crouching - Rarely
Crawling - Rarely
Reaching - Rarely
Handling - Occasionally
Grasping - Occasionally
Feeling - Rarely
Talking - Frequently
Hearing - Frequently
Repetitive Motions - Frequently
Eye/Hand/Foot Coordination - Frequently
Working Conditions
Extreme cold - Rarely
Extreme heat - Rarely
Humidity - Rarely
Wet - Rarely
Noise - Occasionally
Hazards - Rarely
Temperature Change - Rarely
Atmospheric Conditions - Rarely
Vibration - Rarely
Thank you for your interest in Albany Medical Center!
Albany Medical Center is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Thank you for your interest in Albany Medical Center!
Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Auto-ApplyCoding Specialist II, Remote
Somerville, MA jobs
Site: Mass General Brigham Incorporated
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
This role is on the Medical Specialties team.
Seeking experience coding in:
Primary care
E&M
Endocrine
Hematology
Job Summary
Summary:
Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations.
Does this position require Patient Care? No
Essential Functions
Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information.
-Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies.
-Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes.
-Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials.
-Utilize coding software, encoders, and electronic health record systems to facilitate the coding process.
-Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives.
-Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges.
Qualifications
Education
High School Diploma or Equivalent required
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred
Experience
Medical Coding Experience 3-5 years required
Knowledge, Skills and Abilities
- In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing.
- Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations.
- Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes.
- Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding.
- Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff.
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Additional Job Details (if applicable)
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$21.78 - $31.08/Hourly
Grade
4
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
Auto-ApplyRemote - Clinic/Outpatient Coder III
Remote
Remote - Clinic/Outpatient Coder III
Outpatient Coding
PRN Status
Variable Shift
Pay: $24.74 - $37.11 / hour
Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.
Expected to be proficient in assigning ICD-10-CM and/or CPT codes for following types of services: Outpatient: Complex Surgeries, Observations (non-obstetric), Interventional radiology, radiation oncology and/or non-complex inpatient coding encounters. Clinic coder: Either proficient in coding for all non-surgery specialty areas, primary care, or complex surgeries.
This position works under the guidance and supervision of the HIM Outpatient APC and Clinic Coding Manager and is employed by Mosaic Health System.
Codes procedures and diagnoses using the ICD-10-CM, CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards.
Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation.
Communicates with providers, querying providers to ensure the highest level of specificity is provided in documentation.
May assist in training of newly hired coders.
Caregiver may work in conjunction with Patient Financial Services to verify and modify charges and coding to ensure accuracy of supporting documentation, payer rules and correct coding.
Working reports for clean-up, auditing services, edits, and denials.
Ensures data accuracy of State HIDI data by responding to edits received.
Performs other duties as assigned.
Must have coding education, HS Diploma and Medical Terminology and Anatomy and Physiology
Required to obtain CCS - Certified Coding Specialist or RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CPC and/or CCSP - Certified Professional Coder within 180 days of employment. Must also obtain COC - Certified Outpatient Coding within 180 days of employment.
Five years experience in a Health Information Services department performing a job that requires detail, and familiarity with patient medical record preferred.
Remote - Inpatient Coder II
Remote
Remote - Inpatient Coder II
Inpatient Coding
PRN Status
Day Shift
Pay: $24.74 - $37.11 / hour
Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.
This position is responsible for assigning ICD-10-CM and ICD-10-PCS codes for inpatient and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic, anatomy and physiology.
This position works under the supervision of the Manager and is employed by Mosaic Health System.
Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines and organizational compliance standards.
Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation.
Completes complex coding assignments for reimbursement, research and compliance with Federal and State regulations. Researches coding guidelines. Reviews and appeals coding denials.
Educates/Communicates with providers, querying providers to ensure that optimal clinical documentation is provided to demonstrate the severity and details of the patient's illness in the medical record.
Coordinates/Communicates with departments including clinical departments, Quality Improvement, Care Management, Patient Financial Services to ensure accuracy and timeliness of coding.
Ensures data accuracy by responding to coding edits received.
Cross-trained and able to complete one type of outpatient facility coding in addition to inpatient coding. Example: Emergency Department, Observation, Referral.
Mentors and assists with training coders.
Completes analysis by utilizing reports, record reviews, etc.
Other duties as assigned.
Must have coding education. Associate's Degree or higher in Health Information Management / Medical Records required.
CCS - Certified Coding Specialist, RHIA - Registered Health Information Administrator, or RHIT - Registered Health Information Technician required.
Three years experience in coding in an acute care setting required.
Clinical Coder IV/Acute Care - Medical Records
Charlotte, NC jobs
00153661
Employment Type: Full Time
Shift: Day
Shift Details: Monday-Friday 1st shift
Standard Hours: 40.00
Department Name: Medical Records
Location Details: Onboarding at Arrowpoint, after training able to work remote
Carolinas HealthCare System is Atrium Health. Our mission remains the same: to improve health, elevate hope and advance healing - for all. The name Atrium Health allows us to grow beyond our current walls and geographical borders to impact as many lives as possible and deliver solutions that help communities thrive. For more information, please visit carolinashealthcare.org/AtriumHealth
Job Summary
To support World Class Service Lines, and with Documentation Excellence (DE) as the primary objective, the Clinical Coder IV reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate codes for billing, internal and external reporting, research and regulatory compliance. An option to work as part of the clinical team and perform high level, service line based concurrent coding is also available. This position also enjoys the advantages of free CEUs and one paid professional membership.
Essential Functions
Reviews medical records of high complexity to identify the appropriate principal diagnosis and procedure codes, all other appropriate secondary diagnoses and procedure codes. Assign and present on Admission, Hospital Acquired Condition and Core Measure Indicators for all diagnosis codes.
Facilitates appropriate MS-DRG for inpatient medical records and appropriate APC assignment for outpatient medical records using UHDDS and other facility guidelines.
Demonstrates the technical competence to use the facility encoder as it interfaces with the hospital mainframe and/or EMR in an on-site or remote setting.
Reviews charges and Evaluation and Management levels.
Demonstrates proficiency with Microsoft Office Applications and in using required computer systems with minimal assistance.
Abstracts coded data and other pertinent fields in the hospital electronic health record.
Ensures the accuracy of data input.
Meets established quality and productivity standards.
Facilitates peer review and training for all Acute Clinical Coders in the coding department. Provides support to management.
Stay abreast of coding principles and regulatory guidelines related to inpatient and/or outpatient coding.
Physical Requirements
Must be able to concentrate and sit for long periods of time while reviewing electronic health records. Daily and weekly deadlines must be met in a fast paced office environment and/or at home environment.
Education, Experience and Certifications.
High school diploma or GED required; Bachelors degree preferred. Advanced knowledge in Medical Terminology, Anatomy and Physiology and Pharmacology required. 4 years coding experience in acute care setting required. Current RHIA, RHIT, CCS, CPC-H, CPC or CIC required plus a passing score on the CHS Coding test.
At Atrium Health, formerly Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations.
As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve.
Posting Notes: Not Applicable
Carolinas HealthCare System is an EOE/AA Employer
Risk Adjustment Medical Coder
Boone, NC jobs
Job DescriptionDescription:
Full Time, Remote
Exempt / Salary
Organization
High Country Community Health (HCCH) is a federally funded Community and Migrant Health
Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of
HCCH is to provide comprehensive and culturally sensitive primary health care services that
may include dental, mental and substance abuse services to the medically under-served
population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural
communities.
Supervisory Relationship:
Reports to: Deputy CFO
Job Summary and Responsibilities
Provides thorough concurrent, prospective, and retrospective review of ambulatory medical
record clinical documentation to ensure accurate and complete capture of the clinical picture,
severity of illness, and patient complexity of care. Utilizes knowledge of official coding
guidelines, HCC standards, Risk Adjustment Factor (RAF) scoring, and physician query briefs.
Will participate in Provider education on the importance of diagnosis specificity and
documentation guidelines. The Risk Adjustment Coder works to maintain a thorough knowledge
of our current automated eClinicalsWork (eCW) enterprise billing system, through which the
coding and documentation review are functionalized to provide support to HCCH providers and
staffs as necessary. Provides subject matter expertise to others including staff in the Billing
department as necessary. This position requires professional maturity, responsibility, integrity,
and subject matter expertise to complete the work timely; communicate setbacks to deliverables.
and to collaborate with others to meet production and quality standards.
Responsibilities include:
-Review and accurately code medical records and encounters for diagnoses and
procedures related to Risk Adjustment and HCC coding guidelines
-Validate and ensure the completeness, accuracy, and integrity of coded data.
-Concurrently, prospectively, and retrospectively review medical records to identify
unclear, ambiguous, or inconsistent documentation ensuring full capture of severity,
accuracy, and quality.
-Query providers when documentation in the record is inadequate, ambiguous, or
otherwise unclear for medical coding purposes.
-Utilizes approved resources to determine the appropriate ICD-10-CM, CPT, and/or
HCPCS and ensures documentation in the medical record follows official coding
guidelines, internal guidelines, and AHIMA physician query brief standards.
-Comply with the Standards of Ethical Coding as set forth by the American Health
Information Management Association and adhere to official coding guidelines.
-Comply with HIPAA laws and regulations.
-Maintain coding quality and productivity standards set forth by HCCH.
-Maintain competency in evolving areas of coding, guidelines, and risk adjustment
reimbursement reporting requirements.
-Assist in internal and external coding audits to ensure the quality and compliance of
coding practices.
-Provide ongoing feedback to physicians and other providers regarding coding guidelines
and requirements, including education and support for improvement in HCC coding, and
RAF scoring.
-Assist with educational in-services for physicians, other providers, and clinic staff
relating to coding and documentation compliance as well as new policies and procedures
relating to clinical documentation compliance related to billing.
-Maintains complete confidentiality of patient information.
-Assists with developing, implementing, and reviewing policies, procedures, and forms
related to areas of responsibility.
-Other duties as assigned by your Supervisor.
Requirements:
Requirements/Skills/Experience
-High-speed internet access
-Strong clinical knowledge related to chronic illness diagnosis, treatment, and
management.
-Knowledge and demonstrated understanding of Risk Adjustment coding and data
validation requirements is highly preferred.
-Personal discipline to work remotely without direct supervision
-Dental coding skills a plus
-Knowledge of HIPAA, recognizing a commitment to privacy, security, and
confidentiality of all medical chart documentation.
Qualifications:
-Bachelor's degree in allied health or any related field required.
-Minimum 2 years of progressive Professional Risk Adjustment Coding experience
required.
-Active Certified Risk Adjustment Coder certification (CRC and/or CPC) required
-Candidates hired with active CPC, but without Certified Risk Adjustment Coder
certification (CRC) must obtain CRC certification within 9 months of hire.
Travel Requirements
None.
Salary
Commensurate with experience, education and certifications
Home Health and Hospice Coder
San Diego, CA jobs
Job Details LHSD - SAN DIEGO, CA Fully Remote $27.00 - $31.00 HourlyDescription
Who We Are:
Lorian Health is a home health and hospice agency seeking energetic candidates to join our team of skilled professionals. Come join a home health agency that is thoughtful, generous, and family-oriented, placing focus on taking the best care of our patients and our employees!
Lorian Health sets the highest quality standards for home health services in existence today. Foremost of these, is our belief in equanimity in regard to the treatment of all our patients.
Lorian Health is committed to fostering a socially responsible environment within our organization and community and is determined to provide the highest caliber of health care for our patients and their families.
What We Offer:
We offer a comprehensive employee benefits package that includes, but is not limited to:
Health, Dental, Vision, 401K with company match
Competitive pay
Paid vacation, holidays, and sick leave
Full time includes company paid health insurance, dental insurance, vision insurance, paid life insurance, supplemental insurance and 401(k) plan with 4% match, as well as annual accrual of 10 vacation days,10 sick days, 9 holidays.
Join our innovative team to help patients empower themselves to improve self-care.
Qualifications
Requirements:
Must live in Pacific, Mountain or Central Time Zones
Completion of coding specific coursework
Current ICD-10 Coding Certification (HCS-D, BCHH-C, or HCS-H)
Minimum of 1 year previous experience with Home Health ICD-10 coding with verified employment/experience are required.
Minimum of 1 year previous experience with Hospice ICD-10 coding with verified employment/experience are required.
Knowledge of and ability to follow appropriate skilled documentation under Medicare guidelines and conditions of participation.
Knowledge of Patient Driven Grouping Models (PDGM)
Knowledge of insurance reimbursement procedure.
Ability to maintain confidentiality of records and information.
Ability to be flexible, follow verbal and written instruction while working in a team oriented environment.
Detail oriented with critical thinking and strong clinical judgement and analytical skills.
Ability to demonstrate flexibility in response to unexpected changes in work volume and work schedule.
Excellent interpersonal relation skills including active listening, conflict resolution, and team building.
Communicates effectively with the clinical and office staff involved in any given case in a constructive, goal directed, and professional manner
Excellent computer skills to include Microsoft applications (i.e. Word/Excel) and ability to type at least 40 wpm
Preferred:
OASIS certification (COS-C, HCS-O)
Background on OASIS E
Graduate of Bachelor is Science in health field
Experience with HCHB software
HIM Coder - Medical Records - PRN
Topeka, KS jobs
Part time
Shift:
Variable Less than 12 hour shift (United States of America)
Hours per week:
20
Job Information Exemption Status: Non-Exempt Reviews medical record documentation for assigning accurate ICD-10-CM diagnosis, procedure and CPT codes and chart abstracting for hospital related services, including "dual" medical coding, also known as Single Path Coding, for various specialties.
Education Qualifications
High School Diploma / GED Required
Experience Qualifications
2 years Coding experience. Preferred
Skills and Abilities
Knowledge of medical terminology. (Required proficiency)
Knowledge of coding and regulatory guidelines. (Required proficiency)
Licenses and Certifications
Registered Health Information Administrator (RHIA) - AHIMA Required or
Registered Health Information Technician (RHIT) - AHIMA Required or
Certified Coding Specialist - CCS Required or
Certified Professional Coder - AAPC CPC also accepted. Required
Certified Coding Associate - AHIMA CCA also accepted Required
What you will do
Selects and assigns appropriate ICD-10-CM diagnosis, procedure and CPT codes utilizing encoding system and application following coding guidelines.
Ensures appropriate MS-DRG/APR DRG is assigned.
Utilizes Electronic Medical Record (EMR) to identify and enter key administrative and clinical data elements into discrete fields within the EHR.
Comply with all legal requirements regarding coding guidelines and policies.
Proficient with medical necessity documentation guidelines.
Complies with payer specific guidelines for appropriate code assignment.
Works coding queues as assigned by manager or designee.
Collaborates with Clinical Documentation Improvement (CDI) team for clinical expertise and query opportunities.
Submit coding queries to physicians for medical record documentation clarification.
Converse with providers or other health care professionals on coding and/or billing practices, if needed.
Works professionally, independently and completes assignments in a timely manner.
Meets coding productivity and accuracy standards.
Participates at coding and department meetings/huddles.
Participates at CDI/Coding and other educational sessions.
Attends All Employee Meetings.
Continually self-educates on current coding guidelines and regulatory changes utilizing electronic reference material.
Required for All Jobs
Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health
Performs other duties as assigned
Patient Facing Options
Position is Not Patient Facing
Remote Work Guidelines
Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards.
Stable access to electricity and a minimum of 25mb upload and internet speed.
Dedicate full attention to the job duties and communication with others during working hours.
Adhere to break and attendance schedules agreed upon with supervisor.
Abide by Stormont Vail's Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually.
Remote Work Capability
Hybrid
Scope
No Supervisory Responsibility
No Budget Responsibility
Physical Demands
Balancing: Occasionally 1-3 Hours
Carrying: Rarely less than 1 hour
Climbing (Stairs): Rarely less than 1 hour
Crawling: Rarely less than 1 hour
Crouching: Rarely less than 1 hour
Eye/Hand/Foot Coordination: Continuously greater than 5 hours
Feeling: Continuously greater than 5 hours
Grasping (Fine Motor): Continuously greater than 5 hours
Grasping (Gross Hand): Continuously greater than 5 hours
Handling: Continuously greater than 5 hours
Hearing: Occasionally 1-3 Hours
Kneeling: Rarely less than 1 hour
Lifting: Rarely less than 1 hour up to 10 lbs
Operate Foot Controls: Rarely less than 1 hour
Pulling: Rarely less than 1 hour up to 10 lbs
Pushing: Rarely less than 1 hour up to 10 lbs
Reaching (Forward): Occasionally 1-3 Hours up to 10 lbs
Reaching (Overhead): Rarely less than 1 hour up to 10 lbs
Repetitive Motions: Continuously greater than 5 hours
Sitting: Continuously greater than 5 hours
Standing: Occasionally 1-3 Hours
Stooping: Rarely less than 1 hour
Talking: Occasionally 1-3 Hours
Walking: Rarely less than 1 hour
Physical Demand Comments:
Vision requirements include close vision and ability to adjust focus.
Working Conditions
Burn: Rarely less than 1 hour
Chemical: Rarely less than 1 hour
Dusts: Rarely less than 1 hour
Electrical: Rarely less than 1 hour
Explosive: Rarely less than 1 hour
Extreme Temperatures: Rarely less than 1 hour
Infectious Diseases: Rarely less than 1 hour
Mechanical: Rarely less than 1 hour
Noise/Sounds: Occasionally 1-3 Hours
Other Atmospheric Conditions: Rarely less than 1 hour
Poor Ventilation, Fumes and/or Gases: Rarely less than 1 hour
Radiant Energy: Rarely less than 1 hour
Risk of Exposure to Blood and Body Fluids: Rarely less than 1 hour
Risk of Exposure to Hazardous Drugs: Rarely less than 1 hour
Hazards (other): Rarely less than 1 hour
Vibration: Rarely less than 1 hour
Wet and/or Humid: Rarely less than 1 hour
Stormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment.
Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.
Auto-ApplyInpatient Coder II
New Jersey jobs
The Inpatient Coder II is the second level coding position in a 3-tier career ladder. Inpatient Coder IIs will evaluate inpatient medical records and accurately assign the appropriate ICD-10 CM/PCS codes, Present on Admission (POA) indicators, and relevant DRGs. The Coder II must be skillful in the identification and assignment of all diagnoses and procedures in accordance with nationally recognized coding guidelines, as well as researching opportunities to improve documentation.
PRIMARY JOB RESPONSIBILITIES:
Assigns appropriately sequenced and compliant ICD-10 CM/PCS codes as documented in the electronic medical record (EMR).
Applies definition of principal diagnosis for proper assignment of MS-DRGs, APR-DRGs, and POA indicators using a designated encoder/grouper, while ensuring compliance with nationally established coding guidelines.
Utilizes selected encoder and/or computer-assisted coding software (CAC) set forth by client and Accuity.
Abstracts pertinent data from documentation in accordance with client, state, and federal reporting requirements.
Identifies instances in which provider clarification is necessary to ensure quality, completeness of documentation, and optimal, compliant reimbursement and communicates to appropriate channels.
Updates and/or recommends coding changes as necessary due to additions or revisions in physician documentation and Internal Controls and Quality.
Maintains required standards of performance in both coding accuracy and productivity to meet client turnaround and satisfaction.
Records accurate production logs, time keeping, and other relevant tracking information daily.
Performs additional job-related duties as assigned from coding management within pre-determined schedule.
Stays current with most recent coding changes and guidance from CMS, AHA Coding Clinics, AHIMA, Official Inpatient Coding Guidelines, as well as internal education from Physicians, CDI and Coding leadership.
Completes required Continuing Education hours to maintain credential requirements.
Participate in Coding department meetings and other events as assigned.
Maintains a collegial working relationship with other departments.
Accepts coaching, training, and education on a routine basis as needed.
Requirements
POSITION QUALIFICATIONS:
Education:
Minimum HS Diploma or GED required
Coding credential required from AHIMA (RHIA, RHIT, CCS) or AAPC (CPC, CIC)
Associate's or bachelor's degree in HIM or coding preferred
Experience:
Minimum 5 years of current Inpatient facility coding experience; minimum 2 years Level 2 trauma center and/or 2 years academic teaching medical center
Extensive knowledge of ICD-10 guidelines and coding regulations
Demonstrated knowledge in DRG methodologies and compliant reimbursement practices
Knowledge, Skills, and Abilities:
Proficiency in utilizing a variety of EMR systems, EPIC experience preferred
Independently research coding questions and utilize Accuity's internal educational resources
Ability to use a PC in a Windows environment, including MS Word, MS Excel, MS Teams
Autonomous, focused individual able to work remotely or on-site in a rapidly growing organization
Coder (Local SC Remote)
Greenville, SC jobs
Join OBHG: Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination!
Location: SC Upstate area strongly preferred (Remote). Open to exceptional remote candidates in SC, NC, GA (must be located in these states to be eligible).
The Good Stuff We Offer:
Hourly Compensation Range: $21.00 - $24.00 per hour + eligibily for RCM bonus
A mission based company with an amazing company culture.
Paid time off & holidays so you can spend time with the people you love.
Medical, dental, and vision insurance for you and your loved ones.
Health Savings Account (with employer contribution) or Flexible Spending Account options.
Employer Paid Basic Life and AD&D Insurance.
Employer Paid Short- and Long-Term Disability.
Optional Short Term Disability Buy-up plan.
401(k) Savings Plan, with ROTH option.
Legal Plan.
Identity Theft Services.
Mental health support and resources.
Employee Referral program - join our team, bring your friends, and get paid.
Medical Coder Position Summary: The Certified Coder is responsible for the data abstraction, evaluation and auditing of Provider assigned CPT, HCPC codes, ICD-10 CM for obstetrics.
Essential Medical Coder Responsibilities:
Assigns and sequences diagnoses and procedures in accordance ICD-10 CM Official Coding
Guidelines, CPT Assistant, Physician at Teaching Hospital Rules and Evaluation and Management Documentation Guidelines
Experience with billing, collections from insurance companies and patients, insurance follow up, charge entry
Analyze and resolve charge entry coding errors
Familiar with revenue cycle management processes
Ability to work with eBridge, Putty and Lyra software
Report and analyze errors, trends, and findings
Compose reports using Microsoft Excel and Word
Ability to interpret regulatory and payer rules and directives concerning coding
Ability to function in a high volume environment producing quality work
Solid interpersonal and telephone communication skills
Ability to consistently work independently and problem solve
Must be able to multi-task and prioritize job responsibilities
Must be dependable, responsible and team oriented
Strong attention to detail (such as interpretation of clinical data including medical terminology and disease
processes)
Demonstrate a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
Strong working knowledge of HIPAA as it relates to the entire revenue cycle management cycle process
Perform other duties as assigned.
Essential Skills/Credentials/Experience/Education
Certified AAPC Coder
Associate or Bachelor's Degree, OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE
Skill in operating a personal computer; must be proficient in Word, Excel, Power Point.
Ability to compose letters, memos, and other correspondence.
Effective interpersonal skills required in interactions with Ob Hospitalists and personnel.
Ability to work with highly confidential materials.
Must possess high ethical standards.
Enhances professional growth and development through in-service meetings, education, programs, conferences, etc.
Physical Demands (per ADA guidelines)
Sitting for long periods of time. Occupation requires this activity more than 66% of the time (5.5+ hrs/day)
Coder - FT40
Wooster, OH jobs
WOOSTER COMMUNITY HOSPITAL JOB DESCRIPTION
Coder
MAIN FUNCTION:
The Coder is responsible to review, abstract, assign appropriate ICD10-CM, CPT and DRG codes as needed to all patient charts/accounts. Assists the revenue cycle team by performing audits to detect, assess and resolve re-imbursement and revenue compliance concerns. Involved in the charge capture process.
RESPONSIBLE TO: System Director of Revenue Cycle
MUST HAVE REQUIREMENTS:
Previous coding experience / knowledge.
Ability to follow written and verbal directions.
Knowledge of state and federal coding regulations.
Knowledge of Anatomy, Physiology, Disease Processes, and Medical Terminology.
RHIT/RHIA/CCS/ or CCA eligible.
If not credentialed at time of hire, then applicant must become credentialed in one of the four areas within 12 months of hire to remain employed.
Ability to operate computer on a daily basis and perform basic office procedures.
No written disciplinary action within the last 12 months.
PREFERRED ATTRIBUTES:
Completion of an accredited program in Health Information Technology.
* Denotes ADA Essential
* Follows Appropriate Service Standards
POSITION EXPECTATIONS:
* Reviews charts of all inpatient, outpatient surgeries, observations, clinic, special procedures, emergency room records, and outpatient testing or treatment room records, etc. on a daily basis in order to assign proper ICD10-CM and/or CPT codes for billing and statistical reports.
* Utilizes encoder software to code and finalize bill
* Able to prioritize most needed coding and code in a timely manner.
* Abstracts demographic information as needed.
* Works with Manager with problem accounts. Tracks down these accounts and works with the physician to complete these records and codes them for billing.
* Reports any problems in coding, billing or registrations to the Manager.
* Ensures that chart information supports the diagnosis and treatment. Charts must be thoroughly reviewed and discrepancies communicated to the physician for correction or further documentation.
* Performs audits of revenue cycle processes utilizing reports from various software applications (i.e. Craneware, Meditech, Quadex, etc.) and report findings to the Manager.
* Must be able to perform audits utilizing all source documents, including the medical record, itemized charges, UB92 and charging worksheets.
* Performs revenue audits for clinical departments on a rotating basis as well as requested audits on an as needed basis. The need for an audit can be identified by PFS, HIM or clinical departments.
* Performs charge capture processes for the specified categories of charges.
4/95 Revised Dates: 3/00, 6/00, 3/02, 9/03, 1/04, 3/05, 5/09, 11/10, 10/15, 2/20
Approved by Human Resources:
Full time Monday thru Friday 8am-430pm
40 hours per week
HIM Coder Analyst II-REMOTE within State of TX
Fort Worth, TX jobs
Department:
HIM-Coding
Shift:
First Shift (United States of America)
Standard Weekly Hours:
40
The HIM Coder Analyst II requires advanced knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-10-CM and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for ambulatory surgery, special procedure, observation, emergency department, outpatient ancillary and clinic visit records. Primarily codes complex ambulatory surgery and observation visit medical records. Identifies and abstracts specified information from the patient medical record and enters data into the electronic health record system for billing and use in all types of CCHCS reporting. Assists with coding outpatient ancillary clinic, specialty clinic and emergency room record coding as necessary. Minimum expected accuracy rate for all coding assignments is 95%. Communicates with physicians and other providers regarding documentation requirements and collaborates with Clinical Documentation Specialists on patient cases regarding documentation needs and requirements, and coding assignment accuracy. Maintains current knowledge of coding and documentation changes, rules and guidelines.
Education & Experience:
High School Diploma or Equivalent required.
RHIA, RHIT or CCS with one (1) year minimum current and continuous full-time ICD-10-CM& CPT-4 ambulatory surgery, observation and/or inpatient coding and abstracting experience required.
Pediatric coding experience highly desired.
Technically competent and fluent knowledge in navigation of electronic health record applications, automated encoders, and other software applications and hardware required for job role required.
Experience using Microsoft Office Excel and Word highly desired. Ability to work well independently and productively with minimal guidance and without direct supervision.
Must be highly detail oriented, have the ability to remain focused with good organization, interpersonal and communication skills.
Ability to maintain confidentiality.
Goal oriented, flexible and energetic.
Demonstrates coding skills, and critical thinking skills.
Ability to solve problems appropriately using job knowledge and current policies and procedures.
Demonstrated coding knowledge and proficiency is required through on-site skills assessment with a passing score of 90% prior to hire.
Certification/Licensure:
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) required.
Required to provide current American Health Information Management Association (AHIMA) continuing education certification records.
About Us:
Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.
Auto-ApplyInpatient HIM Coder Analyst III-Remote within the state of Texas
Fort Worth, TX jobs
Department:
HIM-Coding
Shift:
First Shift (United States of America)
Standard Weekly Hours:
40
The HIM Coder Analyst III requires superior knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the Present on Admission (POA) indicators for accuracy. Primarily codes more complex and difficult inpatient medical records. Identifies and abstracts specified information from the patient medical record and enters data into the electronic health record system for billing and use in all types of CCHCS reporting. Performs extended length of stay coding for interim cycle billing. During inhouse interim coding, reviews for documentation opportunities and queries with CDIS to clarify confusing, incomplete or conflicting information and obtain any needed additional documentation in real time. Assists with coding outpatient surgery, observation outpatient ancillary clinic, specialty clinic and emergency room record visits as necessary. Minimum expected accuracy rate for all coding & DRG assignments is 95% or above. Communicates with physicians and other providers regarding documentation requirements and collaborates with Clinical Documentation Specialists or Quality Auditors on patient cases regarding documentation needs and requirements, and coding and DRG assignment accuracy. Maintains current knowledge of coding, DRG and documentation changes, rules and guidelines.
Education & Experience:
RHIA, RHIT required, with CCS highly desired, or CCS with two (2) year minimum full-time current and continuous ICD-10-CM/PCS hospital inpatient medical record coding and prospective payment system, experience with DRG assignment.
Outpatient observation and ambulatory surgery with CPT-4 coding and abstracting experience preferred.
Pediatric coding experience highly desired.
Technically competent and fluent knowledge in navigation of electronic health record applications, automated encoders, and other software applications and hardware required for job role required.
Experience using Microsoft Office Excel and Word highly desired.
Ability to work well independently and productively with minimal guidance and without direct supervision.
Must be highly detail oriented, have the ability to remain focused with good organization, interpersonal and communication skills.
Ability to maintain confidentiality.
Goal oriented, flexible and energetic.
Demonstrates superior coding skills, and critical thinking skills.
Ability to solve problems appropriately using job knowledge and current policies and procedures.
Demonstrated coding knowledge and proficiency is required through on-site skills assessment with a passing score of 90% accuracy prior to hire.
Certification/Licensure:
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) required. Required to provide current American Health Information Management Association (AHIMA) continuing education certification records.
About Us:
Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.
Auto-ApplyMedical Records Coder 1
Remote
Inova Health is looking for a dedicated Medical Records Coder 1 to join the HB Coding Operations team. This role is Full-time working daytime hours Monday to Friday | REMOTE.
Inova is consistently ranked a national healthcare leader in safety, quality and patient experience.
We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.
Featured Benefits:
Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
Work/Life Balance: offering paid time off, paid parental leave.
Medical Records Coder 1 Job Responsibilities:
Resolves OCE and medical necessity edits.
Appends or corrects modifiers and resolves NCI, LCD, NCD, OCE and MUE edits when required.
Meets Coding quality standards established by the Coding Operations Director and the Coding Manager.
Makes recommendations to physicians on documentation required to support ICD-10 diagnosis codes.
Ensures that ICD-910-CM diagnosis productivity rate meets minimum standards according to policies and procedures.
Assigns the appropriate ICD-10-CM diagnosis codes to Outpatient records after review of the Outpatient medical record documentation
Minimum Requirements:
Education: High School diploma or GED equivalent and completion of an AHIMA-approved coding or health information technology program.
Certification: CCA, RHIA, RHIT, or CCS certification from AHIMA, or CPC-A, CPC, or COC certification from AAPC upon start.
Auto-ApplyHealth Information Management - HIM - Coder - Inpatient - REMOTE
Rome, NY jobs
Job Description
Health Information Management - HIM - Coder - Inpatient
The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations.
•Understands importance coding plays in the revenue cycle process
•Meets or exceeds coding productivity and quality standards
•Assists with DRG appeals as necessary
•Assists Coding Manager with identifying problems or trends that need immediate attention
•Adheres to all department and hospital policies and procedures
High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required.
KNOWLEDGE AND SKILLS REQUIRED:
Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College.
The best care out there. Here.
Health Information Management (HIM) Coder - Outpatient - PER DIEM
Rome, NY jobs
Job Description
Rome Health is looking for a per diem OP coder to join the Health Information Management team. This team member will assist with backlogs and coverage during staff PTO.
•Current coding certification required •Three years of experience coding Observation and/or Ambulatory Surgery preferred
•Experience with Clintegrity, Paragon, One Content helpful
•Fully remote after training
Extensive knowledge of medical terminology. Experience in researching and applying coding rules and guidelines required.
Must have experience with data entry of codes into a database. Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
Excellent oral and written communication skills. Must have a positive, respectful attitude.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
Health Information Management (HIM) Coder - Outpatient - PER DIEM
Rome, NY jobs
Rome Health is looking for a per diem OP coder to join the Health Information Management team. This team member will assist with backlogs and coverage during staff PTO.
•Current coding certification required •Three years of experience coding Observation and/or Ambulatory Surgery preferred
•Experience with Clintegrity, Paragon, One Content helpful
•Fully remote after training
Extensive knowledge of medical terminology. Experience in researching and applying coding rules and guidelines required.
Must have experience with data entry of codes into a database. Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
Excellent oral and written communication skills. Must have a positive, respectful attitude.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.
Health Information Management -HIM - Coder - Inpatient -REMOTE
Rome, NY jobs
Health Information Management - HIM - Coder - Inpatient
The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations.
Understands importance coding plays in the revenue cycle process
Meets or exceeds coding productivity and quality standards
Assists with DRG appeals as necessary
Assists Coding Manager with identifying problems or trends that need immediate attention
Adheres to all department and hospital policies and procedures
High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required.
KNOWLEDGE AND SKILLS REQUIRED:
Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties.
About Rome Health
Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College.
The best care out there. Here.