Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements and complications. Researches and analyzes data needs for reimbursement. Analyzes medical record and identifies documentation deficiencies. Serves as resource by answering questions and providing leadership to health data analysts.
Essential Functions:
- Reviews documentation and data. Identifies diagnostic and procedural information
- Identifies reportable elements, complications and other procedures. Ensures complete disease and procedure reporting. Verifies documentation supports diagnoses, procedures, and treatment results
- Identifies discrepancies, potential quality of care, and billing issues
- Serves as coding consultant to care providers
- Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions
- Abstracts data elements for administrative/planning reports, reimbursement and research
- Keeps abreast of advances in technology, diagnosis, and treatment of diseases that affect coding and reimbursement changes
- Handles special projects as requested
- Serves as resource by answering questions and providing leadership to health data analysts. Provides ongoing training to staff as needed
- Stays abreast of current regulations to maintain certification
- Performs other duties and accepts responsibility as assigned
Qualifications:
Basic Qualifications:
- Two years of coding and records/data analyzing experience in a health care (acute care) setting
- Experience with ICD-9-CM and CPT4 and HCPCS coding systems, UHDDS definitions, and other related documentation requirements
- Post high school coursework in medical records administration, anatomy, physiology and medical terminology
- Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA)
- Knowledge of and experience in medical record department functions, diagnosis related groups, and prospective payment system
- Knowledge of related laws and regulations
- Demonstrated knowledge of and skill in customer service, oral communication, written communication, problem solving, quality management, results orientation, teamwork, detail oriented, prioritization, organization, independent work and leadership
Preferred Qualifications:
- Associate's degree in related field
- Demonstrated knowledge of and skill in PC navigation, mainframe, internet and intranet
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.