Coder II

POSITION SUMMARY
This position is responsible for accurately coding at least one main outpatient work type accounts (Observation, Same Day Surgery, and/or ER) as well as assisting with the coding of other outpatient work types as needed. All accounts should be completed within 5 days following discharge.

POSITION REQUIREMENTS
Minimum Education Required: Completion of college level course work in Medical Terminology and Anatomy and Physiology.
Preferred: Minimum education level of Associates Degree.

Minimum Work Experience Required: A minimum of two (2) years coding experience in an acute care hospital.

Required Licenses/Certifications Required: CCA credentials (Certified Coding Associate) or CPC credentials (Certified Professional Coder)
Required Skills, Knowledge, and Abilities Required: A through working knowledge of Medicare billing rules, regulations and local medical review policies as they impact reimbursement under APCs and DRGs.

Preferred Qualification Preferred: CCS credentials (Certified Coding Specialist -- Hospital based)
Preferred: RHIT or RHIA credentials

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. Responsible for final coding of outpatient accounts (Observation, Same Day Surgery and/or Emergency Department).
7. Accurately assigns ICD-10-CM and CPT codes to arrive at an APC based on information provided in the patient record.
8. For observation accounts, responsible for capturing ER E/M level charges, injections/infusions charges, and observation hour charges for patients that are admitted to observation.
9. Prompts medical staff physicians for additional documentation as needed to clarify correct assignment of ICD-10-CM diagnosis and CPT procedure code assignment.
10. Responsible for responding to any audited accounts provided by the Audit team within three (3) business days of receipt.
11. 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.
12. Responsible for maintaining an overall coding accuracy rate of 95% or greater.
13. Responsible for ensuring that no accounts remain un-coded > 5 days following patient discharge unless required documentation is needed.