Mandatory COVID-19 guideline:
As of March 15th, 2022, all onsite JSH employees must have received the necessary doses to complete the COVID-19 vaccine series (i.e., one dose of a single-dose vaccine or all doses of a multiple vaccine series) or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC. New hires also will be required to comply with this requirement before working onsite at any JSH facility.
Mandatory COVID-19 guideline:
As of March 15th, 2022, all onsite JSH employees must have received the necessary doses to complete the COVID-19 vaccine series (i.e., one dose of a single-dose vaccine or all doses of a multiple vaccine series) or have been granted a qualifying exemption, or are identified as having a temporary delay as recommended by the CDC. New hires also will be required to comply with this requirement before working onsite at any JSH facility.
Position Summary:
Coding specialists are skilled in classifying medical data from patient records in a hospital setting, demonstrating skills in data quality and accuracy as well as mastery of coding proficiency.
Essential Functions:
- Possess expertise in assigning ICD-10-CM/PCS, CPT-4 and HCPCS codes for diagnoses, treatments and procedures according to the appropriate classification system for inpatient or outpatient encounters.
- Demonstrate extensive knowledge of coding conventions, guidelines, rules and regulations for multiple classification systems to optimize reimbursement.
- Consistently meet defined coding quality and production standards.
- Demonstrate thorough knowledge of medical terminology, anatomy/physiology, disease processes, reimbursement methodologies, and payor-specific guidelines.
- Collaborate with coding leadership by sharing trends and topics for education and feedback to physicians and departments.
- Advanced understanding of APC and MS-DRG grouping methodologies.
- Ability to write compliant queries for clarification to support accurate code assignment, POA, cause-and-effect relationship and sequencing.
- Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adhere to ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinic, CPT Assistant, and ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice.
- Review pre-bill edits and missing data elements.
- Attend continuing education workshops, webinars, etc., for coding compliance and maintenance of CEUs.
- Verify data and discharge disposition to ensure accuracy.
- Additional functions for Inpatient Coders:
- Proficient in DRG optimization
- Proficient in assignment of POA indicators
- Exceptional communication (verbal and written) skills; ability to interact with all levels of the organization effectively; possess high level of organization and ability to work independently, and collaborate with CDI, physicians and other hospital staff.
Organizational Expectations
- Provides a positive and professional representation of the organization.
- Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.
- Participates in ongoing quality improvement activities.
- Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
- Complies with organizational and regulatory policies for handling confidential patient information.
- Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, ○ Mission, and Values of the organization.
- Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and TJC standards and/or standards from other accrediting bodies.
Required Skills
Minimum Education
- High school graduate or GED equivalent
- Anatomy and Physiology I and II, Medical Terminology, Pharmacology concepts (or equivalent)
- Associate or Bachelors’ degree in Health Information Management (or similar program) from an accredited CAHIIM program preferred.
Required Certification
Coder II-IV:
- CCA, CCS, RHIT or RHIA certification required.
- RHIT/RHIA new grads considered (must obtain certification within 6 months of hire).
Required Experience
Outpatient Coder II-III: **** Minimum 3 years verifiable coding experience in acute-care facility setting
Inpatient Coder IV: Minimum 5 years verifiable inpatient coding experience in acute-care facility setting