Senior Coder

CommonSpirit Health•Englewood, CO

About The Position

As a Medical Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Employees will comply with all laws, rules, and regulations relating to the position. The employee has a duty to report any suspected violations of the law to his/her immediate supervisor, compliance officer, or CEO. Employees will follow the coding guidelines set by AHIMA (American Health Information Management Association,) NCCI (National Correct Coding Initiative) edits, CMS (Center for Medicare and Medicaid Services,) and the Standards of Coding Ethics.

Requirements

High School Graduate
High School diploma or GED
Completion of a CAHIIM Approved AHIMA/AAPC Accredited Coding Education
3 years Coding Experience (Hospital Facility, Professional Fee, Physician Clinic) using ICD and CPT coding and/or knowledge of APC’s,DRG’s, modifiers, and other payment methodologies
Electronic Medical Record (EMR) or Cerner experience
Certified Professional Coder

Responsibilities

Selects appropriate assignments for coding from assigned work queues.
Assigns codes by encounter HIM Coders shall use their skills, their knowledge of ICD and CPT rules, guidelines and requirements and any available resources to select appropriate diagnosis and procedural codes.
The HIM Coder is a member of the healthcare team and, as such, shall assist physicians who are unfamiliar with ICD, CPT or DRG methodology.
The HIM Coder is expected to strive for optimal payment to which the facility is legally entitled and will not engage in unethical and illegal practices to maximize payments by means that contradict regulatory guidelines.
Reviews unbilled to assure records are all coded within department timeframes.
Maintains patient, medical record, department, and employee confidentiality at all times.
Consistently demonstrates a positive attitude and fosters teamwork by offering assistance to others as needed.
Effectively uses tools provided to monitor coding backlog and coding errors needing correction.
Works with other departments to correct inaccurate clinical or demographic information regardless of the source of the information.
Reviews the APC grouper edit and assists in clearing the edits related to coding and compliance.
Assists with the orientation and training of new employees.
Provides input to the supervisor regarding coding policies and procedures.
Fulfills yearly continuing education requirements of the department and the hospital, to include safety and mandatory in services.
Responsible for maintaining credentials.
Attends and participates in department or section meetings.
Contributes to the overall operation of the department by performing other duties, as assigned.