HIM Coder IV

8hr Days

Duties:

Job Summary:
-Assigns ICD, CPT and HCPCS coding classifications based on clinical documentation and/or physician orders.
-Utilizes appropriate tools, resources and guidelines to determine codes and assign principal and secondary diagnoses.
-Obtains clarification from physicians, clinical departments and others on documentation questions, as needed.
-Performs coding at an advanced level of coding complexity. Codes for multiple facilities and combinations of hospital chart types.
-Maintains assigned work queues within defined processing timeframe and meets or exceeds productivity standards.
-Runs all inpatient accounts through the Diagnosis Related Group (DRG) analyzer to determine that the codes are sequenced correctly and all code combinations have been considered to assure accurate DRG assignment.
-Verifies data abstracted and entered from the EMR. Ensures integrity of the database for internal and external data reporting.
-Responds in a timely manner to inquiries from Revenue Services related to use of codes and modifiers within the billing process to assure accuracy and avoid delays in the billing process.
-Adheres to all compliance guidelines, both internal and external.
-Participates in continuing education programs to maintain an understanding of anatomy, physiology, medical terminology, disease processes and surgical techniques to support the effective application of coding guidelines and maintain credentials.
-Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
-Performs other duties as assigned.
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Skills:

Required Skills & Experience:
-To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
-The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required.
-Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
-Successful completion of internal coding exam.
-Navigates multiple software systems effectively and efficiently.
-Utilizes critical thinking thought process to assign appropriate clinical diagnosis and procedure codes in accordance with nationally recognized guidelines.
-Maintains knowledge of CPT codes assigned by departments at the time of charging and alerts departments when improper CPT codes are entered to assure accurate billing of accounts. Computer skills and 10-key typing proficiency.
-General software skills with MS Office products, including Word and Excel.
-Strong communication and integrity skills, both verbal and written, in order to interpret medical documents and communicate effectively with medical professionals especially related to compliance guidelines.
-Ability to work independently in a remote environment.
-Demonstrates attention to detail for accuracy requirements.
-Familiar with coding software such as 3M encoder, Epic and computerized assisted coding applications preferred.
-Regular attendance to perform work on site during regularly scheduled business hours or scheduled shifts is required.
-Ability to work nights and/or weekends is required for identified positions.
-Hospital Side Coding; ICD-10-CM & PCS codes.
Preferred Skills & Experience:
-N/A
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