HIM Coder I or II

HIM Coder I or II Shift: Day Employment Status: Full-Time (.75 or greater) Hours per Pay Period: 1.00 = 80 hours every two weeks (Non-Exempt) Starting Wage: DOE: $20.66 - $27.12 Depending on experience and certification, may qualify for a Level I or II HIM Coder. Job Responsibilities Responsible for coding and abstracting diagnoses and procedures from patient charts using ICD-CM, ICD-PCS and/or CPT-4/HCPCS codes for statistical and reimbursement purposes for all Billings Clinic inpatient and outpatient services. Alternatively, responsible for auditing or assigning CPT and E&M codes to clinic encounters by reading dictation, reviewing problem lists and intake forms, capturing primary and secondary ICD-CM diagnoses, adding HCPCS modifiers where necessary and verifying units of service for pharmacy items and supplies. Queries physicians to clarify clinical documentation. Educates physicians either concurrently or after-the-fact on coding and documentation and serves as an on-site resource for providers and staff. Calculates the MSDRG and APR-DRG. Ensures adherence to all Billings Clinic and regulatory compliance policies and procedures governing medical records coding, billing and reimbursement. Essential Job Functions Maintains detailed knowledge of and ensures adherence to all applicable Billings Clinic and regulatory compliance policies/procedures governing medical record coding, insurance billing, and reimbursement methodologies in all aspects of the job. Actively seeks clarification and updated information to ensure most current guidelines are followed. Review medical records for documentation to identify principal diagnosis and/or procedure and all applicable secondary diagnosis and procedures. Assign appropriate ICD-CM and/or CPT-4/HCPCS codes for each encounter utilizing ICD-10 and CPT-4 reference tools. Utilize the computerized encoding system and/or coding books to facilitate accurate coding and sequencing of diagnosis and procedures by following all regulatory compliance policies and procedures governing medical records coding, billing and reimbursement. Maintains or exceeds 95% coding accuracy based on audit findings. Maintains or exceeds department productivity standards for assigned areas of coding. Identifies and reports regulatory or compliance concerns to Coding Resources Manager, Director and/or Billings Clinic Corporate Compliance Department. Ensures data accuracy prior to billing interface and claims submission (i.e., discharge disposition, appropriate use of modifiers, CPT, ICD, performing provider, date of service, POA, NCCI, and other coding and abstracting requirements). Collects data from the medical record to complete a discharge data abstract on each encounter for specialized studies. Communicates with physicians/Non-Physician Providers to provide coding and documentation education and feedback. Identifies needs and sets goals for own growth and development; meets mandatory organizational and departmental requirements. Maintains knowledge of current information and technologies for coding and abstracting arena. Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance. Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements and maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance. Performs all other duties as assigned or as needed to meet the needs of the department/organization. Cross‑Training: Clinic – able to perform diagnosis, E/M and procedure coding for a variety of specialties, both hospital professional and clinic encounters. Will begin training on reimbursement functions by attending department meetings with Coding Resources staff, provide feedback to physicians on hospital professional charges, may begin auditing clinic encounters. Hospital – able to perform coding for all outpatient services and outpatient surgery services. Begin inpatient coding training. Knowledge: Demonstrated and in-depth knowledge and interrelations of coding and reimbursement methodologies and medical record information systems normally acquired as a graduate of an approved medical records program and/or more than 2 years of on‑the‑job experience. Fully understands the ramifications and outcome of coding decisions and the financial impact to the organization. Analytical Skills: Clinic – ability to perform complex coding requirements across several specialties within the physician clinic and will be trained on all specialties; Hospital – ability to perform complex coding requirements within the hospital for ancillary services and outpatient surgery area. Takes action with minimal input or supervision. For situations outside normal guidelines, formulates recommendations for review by the management team. Able to proactively identify reimbursement issues. Independent Judgment: Ability to determine proper procedures for resolving complex coding issues with minimal supervision. Empowered to investigate and research pertinent data and formulate an action plan. Monitors high‑dollar discharges to ensure high levels of coding quality. Presents recommendations for review by the management team for problem scenarios outside established procedures. Interpersonal Skills: Ability to incorporate cultural diversity and age‑appropriate care into communication and services. Responds to complex inquiries from payers and physicians, manages difficult situations, assists training and problem resolution for Level I coders. Supervision of Others: May serve as a resource to Level I staff for procedural questions and problem resolution. Assists management in maintaining high quality coding functions. Process Improvement / Quality Assurance / Risk Management: Must successfully meet and maintain established productivity and quality standards. Maintains detailed knowledge of all applicable Billings Clinic and regulatory compliance policies governing medical records coding, insurance billing and reimbursement methodology. Identifies and reports issues to Manager, Director or Billings Clinic Corporate Compliance Department. Minimum Qualifications Education: Minimum high school or GED; prior training in anatomy, medical terminology and coding. Experience: Clinic – 2 years of coding experience with a physician clinic dealing with multiple specialties and basic reimbursement experience. Hospital – 2 years of coding experience within a hospital dealing with all patient types and all third‑party and government payers. Certifications and Licenses: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) at hire; or an equivalent combination of education and experience will be considered. Employees requiring licensure must be properly licensed/certified and in good standing. Your Benefits Comprehensive and competitive benefits package to all full‑ and part‑time employees (minimum of 20 hours/week), including Medical, Dental, Vision, 403(B) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more. Equal Opportunity Statement Billings Clinic is committed to being an inclusive and welcoming employer, striving to be kind, safe, and courageous in all we do. As an equal opportunity employer, our policies and processes are designed to achieve fair and equitable treatment of all employees and job applicants. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, religion, sex, gender identity, sexual orientation, pregnancy, marital status, national origin, age, genetic information, military status, and/or disability. To ensure we provide an accessible candidate experience for prospective employees, please let us know if you need any accommodations during the recruitment process. #J-18808-Ljbffr