HIM Hospital ER Coding Analyst
About The Position
The HIM Hospital Emergency Room Coder is responsible for accurately assigning ICD-10 CM (Clinical Modification) diagnosis codes and Current Procedural Terminology (CPT) codes for emergency departments. This position is at an intermediate level of complexity and ensures compliance with coding guidelines, documentation requirements, and reimbursement policies, as well as ensures claims meet medical necessity for procedures performed. Essential Functions Reviews and analyzes emergency department records and assign appropriate ICD-10 CM and CPT codes for diagnoses and procedures. Ensures accuracy and completeness of coding and documentation and resolve any discrepancies or errors. Utilizes appropriate tools, resources, and coding guidelines to determine codes and assigns first listed diagnosis and secondary diagnoses codes in addition to CPT procedure codes when appropriate. Follows coding guidelines, regulations, and policies, and adhere to ethical standards of coding practice. Queries physicians or other healthcare providers for clarification or additional information when needed. Submits coded claims to billing department or third-party payers in a timely manner. Verifies data abstracted and entered from the electronic health record (EHR). Ensures integrity of the database for internal and external data reporting. Monitors and responds to coding denials, appeals, and audits. Maintains current knowledge of coding updates, changes, and trends through continuing education and professional development.
Requirements
- High School Diploma or GED required.
- Demonstrates strong knowledge and understanding of medical terminology, medical acronyms, pharmacology, anatomy and physiology and ICD-10-CM/PCS, DRG, and APR-DRG classification systems.
- Ability to complete and pass internal coding exam.
- Demonstrated proficiency in using coding software, electronic health records, and other health information systems.
- Demonstrated excellent communication, interpersonal, and analytical skills
- Ability to work independently and collaboratively in a fast-paced environment
- ICD-10-CM & PCS
- Electronic Health Record
- Anatomy, physiology & pathophysiology
- Accuracy
- Detail oriented
- Coding software
- Interpersonal skills
- Computer literacy
- Coding regulations
- Analytical Skills
Nice To Haves
- Associate degree or higher in health information management, health informatics, or related field. Degree must be obtained through an accredited institution. Education is verified.
- Demonstrated acute care facility coding experience which includes both ICD-10-CM & PCS coding with multidisciplinary service lines.
- Experience with EPIC EHR and 3M 360 CAC (Computer Assisted Coding), using 3M automation tools.
Responsibilities
- Reviews and analyzes emergency department records and assign appropriate ICD-10 CM and CPT codes for diagnoses and procedures.
- Ensures accuracy and completeness of coding and documentation and resolve any discrepancies or errors.
- Utilizes appropriate tools, resources, and coding guidelines to determine codes and assigns first listed diagnosis and secondary diagnoses codes in addition to CPT procedure codes when appropriate.
- Follows coding guidelines, regulations, and policies, and adhere to ethical standards of coding practice.
- Queries physicians or other healthcare providers for clarification or additional information when needed.
- Submits coded claims to billing department or third-party payers in a timely manner.
- Verifies data abstracted and entered from the electronic health record (EHR).
- Ensures integrity of the database for internal and external data reporting.
- Monitors and responds to coding denials, appeals, and audits.
- Maintains current knowledge of coding updates, changes, and trends through continuing education and professional development.
Benefits
- We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
