Overview
This job reviews and accurately codes and abstracts the most complex hospital services, inpatient procedures, overnight/multi-night stay services, and all other complex medical services. The role utilizes appropriate coding guidelines to assign ICD and CPT codes, conforms to applicable Medicare, Medicaid, and other third-party payer guidelines to ensure accurate reimbursement, and collaborates with the Clinical Documentation Improvement team to ensure accurate DRG assignment. The coder works closely with management to resolve problems and meet deadlines.
Education
Required – High School diploma or equivalent.
Preferred – Completion of an American Health Information Management Association (AHIMA) accredited coding program with certification.
Work Experience
Required – 3 years coding experience.
Certifications
Required – Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT).
Knowledge, Skills, and Abilities (KSAs)
Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
Computer skills and dexterity required for data entry and retrieval of information.
Proficiency with Windows-style applications, various software packages specific to the role, and keyboard use.
Knowledge of ICD-9-CM, ICD-10, and coding principals.
Excellent decision making, problem solving, analytical and quality management skills.
Proven ability to code complicated inpatient cases.
Job Duties
Accurately assign ICD-10 codes within established coding guidelines, rules, and regulations.
Review medical documentation and validate that documentation is sufficient to support assigned codes.
Act as a resource by researching patient accounts in response to questions and/or errors.
Consistently comply with established department productivity and accuracy standards.
Collaborate with the CDI nurse to identify documentation improvement opportunities and ensure accurate DRG assignment.
Work in collaboration with team members and other departments to meet departmental monthly goals, which may include DNFB, Pre-AR, denials, and claim edits.
Verify correct discharge disposition based on medical documentation.
Other related duties as required.
Compliance and Regulatory Responsibilities
Remain knowledgeable on current federal, state, and local laws, accreditation standards, or regulatory agency requirements that apply to the assigned area of responsibility and ensure compliance with all such laws, regulations, and standards. Maintain and comply with the company’s Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct.
Physical and Environmental Demands
Light work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly. Physical demand requirements exceed those for sedentary work. The job typically involves walking or standing, pushing or pulling of arm or leg controls, or maintaining a production rate pace. There is no exposure to blood, body fluid or tissue, and employees are not required to perform emergency care or first aid. Risk of exposure to hazardous medications or waste is present due to work within a healthcare setting.
Equal Opportunity Employer
Ochsner Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
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