HIM Coding & System Specialist-Full Time

UHS•Corona, CA

21h•Onsite

About The Position

Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpatient locations serving the Southern California community. With over 6,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services. The Health Information Management (HIM) Coding and System Specialist collaborates with staff across the Region and is responsible for the daily operations of the Inpatient and Outpatient Bill-holds to assist the Coding section with achieving performance goals on a daily, weekly and monthly basis.

Requirements

High School Graduate or equivilent required.
Completion of an introductory course of Medical Terminology required.
Two (2) to Three (3) years of experience in Medical Records required, acute care experience preferred.
Prior knowledge of State and Federal release of information laws preferred.
Must have valid California Driver’s License and reliable transportation.

Nice To Haves

Associate’s degree from an accredited College or University in Medical Records Science preferred.

Responsibilities

Responsible for daily working the Inpatient & Outpatient bill-holds to assist the Coding section with obtaining the Coding Team productivity standards. The Coding Team productivity standard is met when the average unbilled days are less than 4 days out for inpatient and 5 days out for outpatient coding. This will be assessed weekly, every Thursday, at the end of business day.
Daily review Inpatient & Outpatient bill-holds to identify those accounts, which have not been coded to date.
Research reasons why accounts remain on the unbilled reports (i.e. missing diagnosis, invalid diagnosis, no physician order, records not scanned, missing documentation, etc) and follow-up accordingly to facilitate timely completion. This process requires working with other departments and contacting provider offices by telephone and fax for completion of missing documentation and coding queries. Upon completion, notify the responsible coder for final coding.
Works daily with the Physician Liaison Representative in order to ensure providers who have incomplete records affecting the bill-hold are added to the suspension process, facilitating timely record completion.
Monitor and process daily the coding support work lists, within Coding application, for all records held or released with pending receipt of incomplete/missing documentation.
Responsible for ensuring accurate data within the HIM Department as follows: Duplicate Patient Encounters – Researches duplicate encounter numbers when identified to validate if patient should have one encounter or two encounters. When appropriate, merges encounter data/charges in accordance with charging guidelines.
Moving of Charges – Move charges daily when posted to the wrong account. Charges are moved to the correct account only after the accounts have been researched and charges found to be supported by record documentation. If the account has been coded or dropped, requests the Central Business Office (CBO) to re-bill the account.
Corporate Coding Reports – Weekly works the assigned corporate reports to identify problem accounts and forward to the responsible coder for review and correction (i.e missing ED charge report, duplicate ED charge report, etc).
Assists Regional Coding Manager with projects, data reviews, etc to ensure data consistency within the charging/coding functions.
Works with fellow employees inside and outside the HIM Department to ensure timely and accurate charging and coding.
Works with clerical HIM staff and other coders to ensure a smooth workflow process to meet the requirements of the Universal Health Services, Inc. (UHS) Corporate HIM Monthly Operations Report and other HIM Department goals.
Works with the HIM Leadership to provide back-up coverage for correcting Standard Edits to ensure clean data submission to meet State of California Office of Statewide Health Planning and Development (OSHPD) guidelines for timeliness and accuracy in the submission of data. Has a working knowledge of OSHPD’s on-line Medical Information Reporting for California (MIRCal) website.
Attends all charging/coding department meetings. Responsible for taking notes and completing meeting minutes.
Maintains and protects patient confidentiality at all times.
Assists the coders in the process of querying providers appropriately according to coding compliance guidelines, UHS, and HIM Department guidelines. Utilizes telephone, fax machine and eMR message center to communicate with provider/provider’s offices.
Refers problem-coding queries to the Coding Lead for review with possible follow-up with the Regional Coding Manager, as appropriate.
Responsible to read, understand, and abide at all times by the Coder’s Code of Ethics (found in the HIM Coding Policy and Procedure).
Responsible to read current periodicals and reference materials received through the HIM Department and through UHS Corporate directives. Applies this knowledge to daily work in order to minimize errors.
Understands the appropriate documentation requirements for the medical record in order to meet Federal, State, and facility regulations. Reports documentation irregularities to the HIM Operations Manager and/or designee.
Performs other duties as assigned.