Facility Coder III - Revenue Cycle-(2400936)
Principal Duties and Responsibilities
Reviews the medical records of outpatients and/or inpatients to determine the diagnoses that identify the condition(s) for the patient's admission as well as any procedures that were performed.
Lists diseases/conditions stipulated or evidenced by data within the current admission.
Assigns the appropriate codes and modifiers for diagnoses and procedures from ICD-10-CM or CPT-4 while ensuring compliance with all organizations and payers’ coding procedures, policies, and Official Coding Guidelines.
Seeks clarification from the attending physician in cases where documentation is absent, ambiguous or contradictory. Educates the physician regarding appropriate documentation requirements.
Participates in provider documentation educational meetings as necessary.
Ensures tests ordered and performed are covered according to Medicare Limitations of Coverage/Medical Necessity manual and to ensure the appropriate APC/DRG is assigned.
Adheres to outside regulations and requirements, state reporting mandates. Provides coding to minimize the number of days in receivables.
Communicates with Finance Dept. and clinical departments to resolve charge/coding issues as needed, and to evaluate process improvements for prevention.
Maintains reference material on coding problems, updates or clarifications. Keeps up to date on all coding education to maintain coding certification(s).
Shares updated coding education with other coders and acts as a mentor for other facility coders.
Collaborates with the Inpatient Team Leader and the Coding Manager to evaluate workflows within the department as well as with other departments to develop process improvements that will help to improve the efficiency of the revenue cycle.
Maintains excellent customer service skills to both internal and external customers. Answers telephone and takes messages and distributes to appropriate person.
Ensures confidentiality of patient medical records and Catholic Medical Center matters.
Assists in teaching and training new employees and/or students.
Performs or monitors Quality Management audits and special projects.
Participates in appropriate role in disasters, fire drills, and other emergency situations.
Exercises care in the operation and use of equipment and reference materials. Performs routine cleaning and preventative maintenance to ensure continued functioning of equipment. Maintains work area in a clean and organized manner.
Performs similar or related duties as assigned or directed.
Education
High School Diploma or equivalent.
Formal coding education preferred.
Certification in coding (see Licensure)
Experience
Two or more years of relevant coding experience required. Inpatient coding experience preferred.
Licensure
Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or Certified Coding Associate (CCA) required.
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