Experience:
No experience
Employment Type:
Full time
Posted:
7/5/2017
Job Category:
Health Care Provider
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CODER III - MEDICAL CODING
Hoag Memorial Hospital Presbyterian | Newport Coast, California
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Job Description

Full-Time 1st Shift 

 

Reviews clinical documentation and diagnostic results as appropriate to extract data and apply

appropriate ICD-9-CM and/or ICD-10-CM, ICD-10-PCS and/or CPT-4 codes for billing,

internal and external reporting, research and regulatory compliance activities. Resolve error reports associated with the billing processes, identify and report error patterns and when necessary assist in the design and implementation of work flow changes to reduce billing errors. Must meet ongoing productivity and quality metrics as established within the department for each level. Coder may work remote if minimum technology requirements, productivity and quality requirements are met and they sign, and adhere to, the Telecommuter Work Agreement.

 

 

Level I:

ï‚· Identifies chargeable items and facility level for emergency department visits, including observation services, and enters them into billing system.

ï‚· Meet and/or exceed the established quality standard of 95% accuracy rate or better while

meeting and/or exceeding established production standards.

-OR-

ï‚· Utilizes technical coding principles and APC reimbursement expertise to assign appropriate ICD-9-CM , ICD-10-CM and CPT-4 procedures.

ï‚· Assigns codes for diagnoses and treatment according to the appropriate classification system for ancillary outpatient encounters, including modifier assignment.

ï‚· Meet and/or exceed the established quality standard of 95% accuracy rate or better while meeting and/or exceeding established production standards.

Level II:

ï‚· Utilizes technical coding principles and APC reimbursement expertise to assign appropriate ICD-9-CM , ICD-10-CM and CPT-4 procedures.

ï‚· Assigns codes for diagnoses, treatment and procedures according to the appropriate classification system for Outpatient and Emergency Department encounters, including modifier assignment.

ï‚· Identifies chargeable items and facility level for emergency department visits, including observation services, and enters them into billing system.

ï‚· Meet and/or exceed the established quality standard of 95% accuracy rate or better while meeting and/or exceeding established production standards.

 

Level III:

ï‚· Utilizes technical coding principles and APC reimbursement expertise to assign appropriate ICD-9-CM , ICD-10-CM and CPT-4 procedures.

ï‚· Assigns codes for diagnoses, treatment and procedures according to the appropriate classification system for Outpatient ancillary and Emergency Department encounters, including modifier assignment.

ï‚· Reviews professional and hospital inpatient and outpatient surgery medical record documentation and properly identifies and assigns ICD-9-CM, ICD-10 CM, and/or CPT-4 codes for all reportable diagnoses and procedures.

o Determines the correct principal diagnosis, co-morbidities, complications, secondary conditions and surgical procedures.

o Assigns MS-DRG

o Assigns Present on Admission (POA) indicators

o Identifies HAC (Hospital Acquired conditions) and when required, report through established procedures.

o Accurately abstracts Discharge Disposition code.

o Queries physicians per established policy and procedure when documentation is not clear or conflicting.

ï‚· Meet and/or exceed the established quality standard of 95% accuracy rate or better while meeting and/or exceeding established production standards.

ï‚· Keeps abreast of coding guidelines by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings.

ï‚· Performs other duties as assigned.

 

Education, Training and Experience

Level I

Required: High school diploma or equivalent. Two years of hospital acute care OP diagnostic coding experience.

Preferred: Successful completion of a certified coding program. Credentials to include one or a combination of the following: CCA, CCS, CCS-P, RHIT and/or RHIA. CPC and/or CPC-H will be considered with relevant outpatient coding experience.

Level II

Required: Two years of progressive hospital acute care coding experience including ER , outpatient procedure and same day surgery. Successful completion of a certified coding program. Credentials to include one or a combination of the following: CCA, CCS, CCS-P, RHIT and/or RHIA. CPC and/or CPC-H will be considered with relevant outpatient coding experience.

Level III

Required: Five years or greater of progressive inpatient (IP) coding experience in an acute

care facility. Credentials to include one or a combination of the following: RHIA, RHIT, and/or CCS.

Preferred: Academic or level I or II trauma center experience. Two years of progressive OP diagnostic and emergency room coding experience.

 

Skills or Other Qualifications

Required: Ability to code and maintain corporate/department specific quality standards

and meet productivity standards as documented by the department and

organization. Knowledge of medical terminology, anatomy and physiology,

disease process and minor surgical procedures. Knowledge of accepted medical

abbreviations and their meanings. Knowledge in the use of specialized

references such as the ICD-9-CM and CPT-4 books, medical dictionaries and

texts, and medical journals. Must have extensive knowledge of Coding Clinic,

CPT Assistant, and all official coding guidelines. Advanced knowledge of

hospital information systems, encoders and other technology to facilitate a

successful virtual work environment while maintaining maximum

communication and adhering to HIPAA security standards. Advanced

knowledge of MS Excel, Word and Outlook functions. Abides by the standards

of Ethical Coding as set forth by the American Health information Management

Association (AHIMA) and adheres to all official coding guidelines. Technical

skills required to learn and navigate a variety of software systems, trouble-shoot

computer problems, install periodic updates to software programs and work

efficiently in a virtual environment. Strong written and verbal communication

skills. Ability to think/work independently, yet interact positively with a remote

team. Advanced problem-solving skills. Familiarity with current healthcare

based technology, coding, and Electronic Health Record (HER). Attention to

detail is crucial to this position.

Preferred: Knowledgeable in Revenue Cycle department functions relating to Ambulatory

Payment Classification (APC) grouping, denials and edits.

About Hoag Memorial Hospital Presbyterian

Located on the bayside bluffs overlooking Newport Beach, Hoag Memorial Hospital Presbyterian stands atop the list of the finest medical facilities in Southern California. Fully accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and designated as a Magnet hospital by the American Nurses Credentialing Center (ANCC), Hoag Memorial Hospital Presbyterian is a 511-bed acute care, not-for-profit hospital that provides a quality work environment and quality lifestyle. This unique combination provides an enriching environment like no other.

A quality work environment and quality lifestyle enables our nurses to chart a satisfying course for every area of their lives - professional, family, friends and personal pursuits. Along with Hoag's commitment and family-oriented approach to providing the highest quality patient care, there is an indisputable pride in the way we fulfill our healing mission.

We invite you to be a part of the dynamic and rewarding career opportunities available at our top-rated medical facility, while enjoying the added luxury of the renowned Southern California lifestyle.

Take a look inside and we believe you'll see why there is no place like Hoag.

View available openings at Hoag Memorial Hospital Presbyterian

 

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About Hoag Memorial Hospital Presbyterian

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