Codes diagnoses and procedures of inpatient records and abstracting information at defined facilities for reimbursement, research, and to generate statistical data. Performs other duties as assigned.
Codes diagnoses and procedures of records pertaining to inpatient records.
Abstracts information by reviewing records for reimbursement, statistical purposes for the daily operations, medical staff, and regulatory agencies.
Serves as a resource to physicians, physician office staff, clinical documentation specialists, case managers, etc.
Completes assigned goals.
Skill in communicating clearly and effectively using standard English in written, oral and verbal format to achieve high productivity and efficiency. Skill to write legibly and record information accurately as necessary to perform job duties.
Skill and proficiency in coding inpatient records utilizing ICD CM and CPT through a minimum of 2 years' experience in an acute care facility, 4 years preferred.
ICD-CM Diagnosis and Procedure Coding.
One of the following: Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT).