Experience Inc. Jobs

Description

Position Summary: Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and/or CPT codes for billing, internal and external reporting, research, and regulatory compliance. Under the direction of the HIM Coding Manager, accurately codes conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting and/or CPT Assistant. Demonstrates knowledge of reimbursement methodologies and applies to assigned charts in order to optimize reimbursement and/ or resolve regulatory edits. 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.

Key Responsibilities:

• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines and keeps abreast of coding changes and interpretation of codes.
• Complies with RRH & HIM department policies & procedures
• Reviews appropriate provider documentation to identify & assign diagnoses & surgical procedure or treatment codes using ICD-10-CM and CPT procedure codes as defined in facility specific guidelines.
• Meets established departmental productivity guidelines for the specific type of coding being performed with 95% accuracy on a consistent basis.
• Utilizes Care Connect, UDS and Clintegrity systems proficiently to obtain ICD10-CM and CPT codes
• Utilizes technical coding principals and APC/E-APG reimbursement expertise to assign appropriate ICD-10-CM diagnoses and CPT procedure codes
• Adheres to compliance of Medicare, Medicaid & Commercial risk adjustment guidelines with precision.
• Formulates compliant coding queries when documentation is inadequate, ambiguous or unclear for coding purposes
• Enters and/or updates data accurately in various systems as departmental policy indicates.
• Completes other duties as assigned by HIM leadership.
• Provide assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process
• Assigns appropriate discharge disposition and/or modifiers based on established coding guidelines.
• Analyzes clinical documentation to determine charge capture requirements for numerous clinical services.
• Uses reports and application queues to identify targeted accounts on a daily basis. Works with CDM team to ensure appropriate charges are in place and that associated CPT codes are current.
• Corrects failed claim errors to billing edits, accounts misclassified and/or other errors identified through various auditing processes in a timely manner.
• Attends RGHS, HIM Department and Coding Team meetings and training sessions as required.
• Ensure timely reporting for external regulations

Minimum Qualifications:
AAS or BS in Health Information Technology or Associates degree in business or health related field, preferred Graduate of recognized coding and billing program, required.
3-5 years of progressive coding experience in a hospital or multi-specialty physician practice setting, preferred

Will consider a recent graduate of above programs

Required Skills:
Successful completion of AHIMA or AAPC approved Coding Certificate required.
Advance coding certification credential: CCS, CCS-P, CPC, CPC-H, CMC, preferred.

RHIT/RHIA certification, preferred

Will consider RHIT eligible candidate who sits for the exam within one year of hire
For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification required within 16 months of hire.

EDUCATION:

• AS: Health Information Management (Required)

PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PAY RANGE: $20.50 - $27.50

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran

Minimum Salary: 20.50 Maximum Salary: 27.50 Salary Unit: Hourly