Coder- Physician Billing

LCMC Health

3d•Onsite

About The Position

The Coding Specialist I will be responsible for applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters, and ambulatory/provider-based clinics. This role involves proficiently navigating patient health records and other computer systems to accurately determine diagnosis and procedure codes, MS-DRGs, APCs, CPT/HCPCs assignments, and all required modifiers. The position also requires validating charges against health record documentation, communicating effectively with clinical staff, physicians, office staff, and Clinical Documentation Improvement Specialists regarding documentation needs, and identifying and escalating concerns to appropriate leadership for resolution. The role is responsible for resolving moderate to complex problems and tracking issues that require follow-up to ensure timely coding. The Coding Specialist I must consistently meet coding quality and productivity standards, adhere to LCMC confidentiality requirements, and maintain up-to-date knowledge of coding and reimbursement guidelines, regulations, laws, and ethical standards.

Requirements

1 year of experience in outpatient or inpatient coding is required.
High School Diploma, GED or equivalent or appropriate work experience is required.
Working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping and components of charge description master for charging functions and understanding when to use the appropriate modifiers.
Must possess knowledge of third-party reimbursement regulations and billing practices.
Experience utilizing encoding/grouping software.
Ability to use standard desktop and windows-based computer system, including basic understanding of email, internet, and computer navigation.
High ethical standards.
Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines.
Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters.
Knowledge of hospital and professional coding including provider-based billing.
Knowledge of documentation regulations of Joint Commission and CMS.
Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices.
Strong analytical abilities and problem-solving skills.
Excellent oral, written and interpersonal communication skills.
Ability to organize and set priorities to ensure objectives are met in a timely manner.
Ability to adapt to change and handle challenges proactively and with pose.
Ability to effectively collaborate with physicians and managerial staff at all levels.

Nice To Haves

Coding experience in Hematology/Oncology.
Experience in assisting and identifying learning needs as well as providing training to coding staff.
Certified Professional Coder from the American Academy of Professional Coders (AAPC)
Certified Outpatient Coder from the American Academy of Professional Coders (AAPC)
Certified Inpatient Coder from the American Academy of Professional Coders (AAPC)
Certified Professional Coder – Payer from the American Academy of Professional Coders (AAPC)
Certified Risk Adjustment Coder from the American Academy of Professional Coders (AAPC)
Certified Coding Associate from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA
Registered Health Information Technician from the Commission on Certification for Health Informatics and Information Management (CCHIIM)
Certified Coding Specialist from the Commission on Certification for Health Informatics and Information Management (CCHIIM)

Responsibilities

Applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters, and ambulatory/provider-based clinics.
Proficiently navigating the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers.
Validating charges by comparing charges with health record documentation as necessary.
Communicating effectively with clinical staff, physicians, office staff, and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
Identifying concerns and notifying appropriate leadership for resolution.
Providing resolution to moderate to complex problems.
Tracking issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion.
Consistently meeting coding quality and productivity standards established by coding department.
Adhering to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information.
Maintaining up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
Performing other duties as assigned by leadership.
Maintaining working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Benefits

LCMC Health is a community. Our people make health happen.
While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way.
Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary
Deliver healthcare with heart.
Give people a reason to smile.
Put a little love in your work.
Be honest and real, but with compassion.
Bring some lagniappe into everything you do.
Forget one-size-fits-all, think one-of-a-kind care.
See opportunities, not problems – it’s all about perspective.
Cheerlead ideas, differences, and each other.
Love what makes you, you - because we do
You are welcome here.
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities.
LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
Simple things make the difference.
To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information.
To ensure quality care and service, we may use information on your application to verify your previous employment and background.
To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed.
To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.
One-of-a-kind care comes from one-of-a-kind people. At LCMC Health, our people are the magic ingredient that makes our care so extra-extraordinary. We are compassionate, driven, and dedicated to bringing a little something extra to healthcare and to the people of New Orleans and beyond. If you’re the kind of person who believes that our community deserves the best and that healthcare needs a little more heart, we want you to be a part of our family. From medical roles to administrative positions, every person on our team plays a part in our mission: to provide health, care, and education beyond extraordinary. Let’s make every day extraordinary, together.