Coder I

Job Title

This position is responsible for coding outpatient clinical and outpatient recurring accounts. All accounts should be completed within three (3) days following discharge.

Position Supervisory Responsibilities

Reports To: HIM Coding Manager

Supervises: None

Position Requirements

Minimum Education: Completion of college level coursework in Medical Terminology and Anatomy and Physiology.

Minimum Work Experience: Preferred: A minimum of one (1) year coding experience in an acute care hospital. A basic working knowledge of Medicare billing rules, regulations and local medical review policies as they impact reimbursement under APCs.

Required Licenses/Certifications: CCA credentials (Certified Coding Associate) or CPC credentials (Certified Professional Coder)

Required Skills, Knowledge, and Abilities: A through working knowledge of Medicare billing rules, regulations and local medical review policies as they impact reimbursement under APCs.

Preferred Qualification: CCS credentials (Certified Coding Specialist -- Hospital based), RHIT or RHIA credentials, Minimum education level of Associates Degree.

Physical Requirements

Will work onsite and/or remotely from home; must reside in the state of Texas. Must be able to work in a virtual setting. Primarily sedentary work reviewing records and keying information using a computer monitor and keyboard. Quiet surrounding with adequate lighting.

Quality Behavioral Expectations

Generally and in all job specific duties: Uses critical thinking skills to determine evidence based solutions. Systematically gathers and reviews pertinent information to prevent errors (PDCA -- Plan, Do, Check, Act). Pursues individual or team learning and growth opportunities to continually build skills. Understands and abides by all safety regulations.

Service Excellence Behavioral Expectations

Generally and in all job specific duties: Maintains patient confidentiality. Rounds regularly with patients, direct reports and/or customers. Uses telephone and elevator etiquette. Acts as an employee ambassador. Committed to know hospital service lines and shows pride in our organization. Uses AIDET when dealing with internal or external customers.

Fiscal Responsibility Behavioral Expectations

Generally and in all job specific duties: Takes responsibility for solving problems. Treats company resources responsibly. Performs work functions timely and accurately. Respects our environment; keeps public areas neat and clean and returns supplies to the appropriate areas.

People Behavioral Expectations

Generally and in all job specific duties: Supports the team through good attendance. Maintains a professional appearance. Creates a positive team environment; flexible and supportive setting an example of cooperation. Uses meaningful communication; provides honest feedback that is valuable and not critical and discourages negative talk and gossip. Respect co-workers.

Job Specific Functions

1. Demonstrates an understanding of and adherence to the HMHD Compliance Plan.
2. Conduct reflects HMHD's values and a commitment to HMHD's Code of Conduct.
3. Attends the required corporate integrity and compliance training and education programs.
4. Demonstrates proficiency in understanding the materials presented during the corporate integrity and compliance training and education program.
5. Complies with all HIPAA standards.
6. Consistently meets monthly productivity expectations.
7. Responsible for final coding of outpatient clinical and/or recurring accounts with an average turnaround time of three (3) business days.
8. Responsible for accurately assigning ICD-10-CM and applicable CPT codes based on information provided in the patient record, while maintaining an overall coding accuracy rate of 95% or greater.
9. Responsible for responding to any audited accounts within three (3) business days of receipt.
10. Responsible for responding to Patient Financial Services (PFS) questions regarding coding assignments that generate errors within the billing editor within three (3) business days of receipt.
11. Communicates with outpatient ancillary departments to obtain additional documentation as needed to clarify correct assignment of ICD-10-CM diagnosis and CPT procedure code assignment.
12. Responsible for completing continuing education requirements to maintain coding credential. Must obtain a minimum of ten (10) continuing education units per year.
13. Assists with other special projects as requested by the HIM Coding Manager and/or the HIM Department Director.