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.
JOB SUMMARY:
The Coder II is responsible for assigning diagnostic and procedural codes to patient charts of moderate complexity using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding guidelines, regulations and JSH coding policies. The Coder II will abide by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record.
The Coder II reflects the mission, vision, and values of JSH, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
ESSENTIAL FUNCTIONS:
- Assign codes for diagnoses, treatments, ancillary services, and procedures according to the appropriate classification system for inpatient and/or outpatient encounters.
- Demonstrate extensive knowledge of coding conventions, rules and regulations for multiple classification systems to ensure optimal reimbursement.
- Meet defined coding accuracy and production standards and demonstrate a thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, and Payor specific guidelines.
- Notify coding leadership of trends and topics for education and feedback to physicians and departments.
- Knowledge of types of health information and the rules and regulations surrounding their use.
- Advanced understanding of coding grouping methodologies.
- Contact physicians and other health care professionals when needed or formulate appropriate physician queries for clarification about treatments or diagnostic tests given to patients to support accurate code assignment and sequencing.
- Extract required information from source documentation and enter into encoder and abstracting system.
- 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, and ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice.
- Review daily pre-bill edits and coding errors to make corrections or complete missing data elements.
- Resolve error reports associated with billing process, identify and report error patterns and, when necessary, assist in design and implementation of workflow changes to reduce billing errors.
- Work collaboratively to ensure the most accurate and complete documentation to support accurate code assignment.
- Attend continuing education workshops, webinars, etc., for coding compliance and maintenance of CEUs.
- Verify data and discharge disposition to assure coding compliance.
- Validate documentation supports the charges prior to coding completion.
Required Skills
THE CODER II WILL BE RESPONSIBLE FOR:
- Maintenance of confidential information encountered in every task associated with this job
- Compliance with ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinic, as well as any governmental coding regulations
- Coding knowledge of multiple specialties including but not limited to Ancillary, Physical Therapy, Occupational Therapy, Speech Therapy, Cardiac Rehab and Pulmonary Rehab
- Working with other Coding team members to meet DNFB benchmarks
- Consistently meet productivity and quality (95%) benchmarks
Required Experience
QUALIFICATIONS:
- An Associate’s degree in Medical Record Technology/Health Information field OR completion of a coding certificate program from an AHIMA or CAHIIM accredited school
- Registered Health Information Management Administrator (RHIA), Registered Health Information Management Technician (RHIT), and/or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA).
- Outpatient and acute care hospital coding experience preferred
- Must possess in-depth knowledge of ICD-10-CM coding classifications, billing requirements
- Must be knowledgeable of encoding software
- Knowledge of specific coding guidelines and Coding Clinic guidelines. Demonstrates proficiency in the use of computerized information systems.
- Demonstrates proficiency with 3M encoder, CAC (computer assisted coder) CCI edits and medical necessity
- Candidate must demonstrate coding proficiency by scoring a 75% or higher on a coding assessment
- Ability to work independently and collaborative with members of the health care team
- Able to demonstrate effective interpersonal and communication skills to promote cooperation from health care team, providers, payers, patients and their families.