Coder, Certified

Shenandoah Medical Center•Shenandoah, IA

About The Position

This role involves accurately coding and sequencing diagnoses and procedures according to coding guidelines, abstracting clinical information for optimal reimbursement, and reviewing documentation to determine diagnoses and procedures performed. The certified coder will assign charge master codes and modifiers for appropriate billing and sequencing, utilize multiple information systems to enter billable charges, and participate in audits to capture lost charges and ensure billing accuracy. Responsibilities also include maintaining contact with staff and providers regarding documentation issues and collaborating with healthcare providers, compliance, and coding teams to identify changes that maximize reimbursement. The position requires professional growth through personal educational objectives to maintain coding knowledge and regulatory requirements, including participation in opportunities to adhere to professional standards. This includes planning and implementing a self-development program to meet continuing education requirements for various certifications (CPC, COC, CCS, CCS-P, RHIT, RHIA). The role demands organizational skills, self-motivation, and flexibility in meeting objectives, along with maintaining current knowledge of national NCCI Coding standards, JCAHO/CMS criteria, ICD-10 CM/PCS, CPT-4, and HCPCS. Providing feedback and education on code changes and organizing data to identify documentation trends for staff and providers are also key aspects. The role also requires compliance with all departmental and organizational policies, procedures, and regulatory requirements (OSHA, CMS, Joint Commission, etc.), participation in safety and quality activities, and performing other assigned duties.

Requirements

Certified coder (CPC, COC, CCS, CCS-P, RHIT, or RHIA)
Knowledge of coding guidelines
Ability to abstract clinical information
Proficiency in using multiple information systems
Understanding of charge master codes and modifiers
Knowledge of ICD-10 CM/PCS, CPT-4, and HCPCS
Familiarity with NCCI Coding standards, JCAHO/CMS criteria
Organizational skills
Self-motivation
Flexibility

Nice To Haves

Active contact with staff and providers on missing or inaccurate documentation.
Active contact with departments to resolve billing issues.
Communication and collaboration with healthcare providers/ compliance/coding.
Developing personal educational objectives.
Planning and implementing a program for continuing self-development.
Maintaining current knowledge of national NCCI Coding standards of practice, JCAHO/CMS, and criteria appropriate to coding and billing.
Maintaining current knowledge of changes in ICD-10 CM/PCS, CPT-4 and HCPCS.
Providing feedback and education on codes that are changed or no longer appropriate for billable items.
Organizing data to allow for identification of documentation trends to provide feedback to staff and other healthcare providers to allow for increased capture of billable items.
Compliance with all departmental and organizational policies and procedures in addition to regulatory requirements (such as OSHA, CMS, Joint Commission, etc.).
Participation in corporate/departmental safety and quality activities.

Responsibilities

Accurately codes and sequences diagnosis and procedures according to coding guidelines and abstract accurate clinical information for optimum reimbursement.
Reviews documentation to determine the diagnosis and procedures performed.
Assigns charge master codes, modifiers for appropriate billing and sequencing.
Uses multiple information systems to accurately select the correct patient account to enter patient billable charges.
Participates in audits to capture lost charges and determine accuracy of billing and coding.
Maintains active contact with staff and providers on missing or inaccurate documentation.
Maintains active contact with departments to resolve billing issues.
Communicates and collaborates with healthcare providers/ compliance/coding on identifying changes in documentation that may lead to maximizing reimbursement.
Demonstrates professional growth by developing personal educational objectives to maintain coding knowledge and regulatory requirements and participating in opportunities to assure continued adherence to professional standards and the provision of highest quality care.
Plans and implements a program for continuing self-development to meet continuing education requirements for CPC, COC, CCS, CCS-P, RHIT, and RHIA certification.
Demonstrates organizational skills, self-motivation and flexibility in meeting personal, professional and institutional objectives.
Maintains current knowledge of national NCCI Coding standards of practice, JCAHO/CMS, and criteria appropriate to coding and billing.
Maintains current knowledge of changes in ICD-10 CM/PCS, CPT-4 and HCPCS.
Provide feedback and education on codes that are changed or no longer appropriate for billable items.
Organizes data to allow for identification of documentation trends to provide feedback to staff and other healthcare providers to allow for increased capture of billable items.
Complies with all departmental and organizational policies and procedures in addition to regulatory requirements (such as OSHA, CMS, Joint Commission, etc.).
Participates in corporate/departmental safety and quality activities.
Performs other duties as assigned.