Coder Senior - DRG coding

Geisinger

1d • Remote

About The Position

Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Relevant experience may be a combination of related work experience and/or completed specialty training program (1 year of specialty training = 1 year relevant experience).

Requirements

• One relevant certification from AHIMA or AAPC is required upon hire. Acceptable certifications include: AHIMA (American Health Information Management Association): Certified Coding Specialist (CCS) Certified Coding Specialist – Physician-based (CCS-P) Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Certified Coding Associate (CCA) – Candidates with only a CCA are required to obtain a CCS, RHIT, or RHIA within 12 months of hire. All certifications are acceptable from AAPC (American Academy of Professional Coders) except: Scribe, Documentation, Instructor, and International Credentials Certified Professional Biller (CPB) Revenue Cycle Management Specialist (RCMS) Certified Value-Based Administrator (CVBA) Certified Physician Practice Manager (CPPM) Certified Professional Compliance Officer (CPCO)
• High School Diploma or Equivalent (GED)- (Required)
• Minimum of 7 years-Relevant experience (Required)
• Communication
• Computer Literacy
• Medical Records Management
• Medical Records Systems
• Teamwork
• Working Independently

Responsibilities

• Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient severity and comply with standard provider coding regulations.
• Carefully details review of documents such as laboratory findings, radiology reports, various scan reports, discharge summary, history and physical, consultations, orders, progress notes and other ancillary services treatment records needed to ensure all pertinent diagnoses and procedures are recorded.
• Translates all diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes as required.
• Using the Encoder software program, determines the codes for all diagnoses and procedures.
• Determines their sequencing to legally maximize reimbursement.
• Assigns the appropriate DRG.
• Assigns codes based on hospital and professional coding guidelines, Coding Clinic directives, federal regulations, CCI coding initiatives, CPT Assistant or other standard coding guidelines.
• Queries physicians as needed to clarify documentation within the patient’s record to facilitate complete and accurate coding.
• Communicates to Coding Quality and Professional Manager any new diagnoses, procedures, technologies, etc. documented within patient records to ensure that appropriate diagnosis and procedure codes are selected and incorporated into hospital and professional coding guidelines.
• Provides and arranges training for coding professionals in the use of coding guidelines and practices, proper documentation techniques, medical terminology, and disease processes.
• Completes coding quality audit reviews to ensure all available cases were coded and entered into the hospital and professional computer system correctly and initiates Claim Action Reports as necessary.
• Develops coding policy and procedure or position papers related to correct coding for new or emerging technology services provided by clinical staff, and train coders on the use of that policy and procedure.

Benefits

• We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.
• Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.
• We know that a diverse workforce with unique experiences and backgrounds makes our team stronger.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED