PACE Medical Coder

San Ysidro Health•San Diego, CA

10h•Hybrid

About The Position

The PACE Medical Coder will review clinical documentation and diagnostic results as necessary to verify the appropriate assignment of the ICD-10 CM, CPT and HCPCS codes as per Official Guidelines for Coding and Reporting. This position is intended to be a hybrid role, where the incumbent will be expected to primarily work remotely. There is a minimum monthly on-site requirement; additional on-site presence may be required based on business need. Essential Functions of the Job: Reviews the Chart Progress Notes, patient documentation for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers. Determines all HCC codes associated with patient encounters.Keeps up to date with the latest CMS risk adjustment guidelines. Verifies all diagnostic procedural codes from the electronic health record using ICD-10 CPT and HCPCS coding classifications. Communicates effectively with providers concerning documentation to assure proper coding and reimbursement. Identifies all chargeable items within each progress note to ensure proper CPT/HCPCS codes for each of the items. Applies sequencing guidelines for the diagnosis codes and selection of the principal diagnosis and procedure according to ICD-10 guidelines Tracks open/close encounter reports to assure that all patients seen in the clinic are properly coded. Organizes & prioritizes all work to ensure that records are coded in time frames that will be in line with department policies. Maintains knowledge of Anatomy & Physiology to interpret general medical classifications for coding including the most complicated encounters/cases. Acts as an expert resource person to other coders & personnel in other departments regarding coding questions & issues. Participates in ongoing education, including in-service training and other activities to maintain and improve competence. Adheres to SYHC's Core Competencies and professional Code of Conduct Behavior Standards in their day-to-day work by consistently demonstrating the Core Values of Respect, Excellence, Integrity and Empowerment. Performs any other related job duties as assigned and/or requested Additional Duties and Responsibilities: Adheres to all applicable SYHC's Policies, Procedures and processes Demonstrates skills in collaboration with team and problem-solving Excellent written and oral communication skills Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops Attends meetings as required and participates on committees as directed Demonstrates courtesy and treats every patient and employee with dignity in every interaction Assists in the maintenance and/or revision of established Departmental Policies and Procedures Maintains confidentiality of all patient electronic medical records Maintains a clean, safe, and organized work area at all times Performs all other related duties as assigned or requested

Requirements

Zero (0) to One (1) year of medical coding experience required with CPC-A certification
One (1) year of medical coding experience required with a CPC/CRC or CCS
High School Diploma or GED Equivalent
Certified Professional Coder (CPC; CPC-A may be considered) or Certified Risk Adjustment Coder (CRC) from the American Academy of Professional Coders (AAPC); or Certified Coding Specialist (CCS) from the American Health Information Management Association certification required
Good oral and written communication skills
Good customer service skills
Extensive knowledge of medical terminology, human anatomy and physiology
Knowledge of diagnostic tests, procedures, pathology terms and drug reference books.
Knowledge of ICD-10-CM and HCPCS/CPT, HCC coding & abstracting procedures
Proficient in typing skills and experience with using computers and software systems

Responsibilities

Reviews the Chart Progress Notes, patient documentation for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers.
Determines all HCC codes associated with patient encounters.
Keeps up to date with the latest CMS risk adjustment guidelines.
Verifies all diagnostic procedural codes from the electronic health record using ICD-10 CPT and HCPCS coding classifications.
Communicates effectively with providers concerning documentation to assure proper coding and reimbursement.
Identifies all chargeable items within each progress note to ensure proper CPT/HCPCS codes for each of the items.
Applies sequencing guidelines for the diagnosis codes and selection of the principal diagnosis and procedure according to ICD-10 guidelines
Tracks open/close encounter reports to assure that all patients seen in the clinic are properly coded.
Organizes & prioritizes all work to ensure that records are coded in time frames that will be in line with department policies.
Maintains knowledge of Anatomy & Physiology to interpret general medical classifications for coding including the most complicated encounters/cases.
Acts as an expert resource person to other coders & personnel in other departments regarding coding questions & issues.
Participates in ongoing education, including in-service training and other activities to maintain and improve competence.
Adheres to SYHC's Core Competencies and professional Code of Conduct Behavior Standards in their day-to-day work by consistently demonstrating the Core Values of Respect, Excellence, Integrity and Empowerment.
Performs any other related job duties as assigned and/or requested
Adheres to all applicable SYHC's Policies, Procedures and processes
Demonstrates skills in collaboration with team and problem-solving
Excellent written and oral communication skills
Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops
Attends meetings as required and participates on committees as directed
Demonstrates courtesy and treats every patient and employee with dignity in every interaction
Assists in the maintenance and/or revision of established Departmental Policies and Procedures
Maintains confidentiality of all patient electronic medical records
Maintains a clean, safe, and organized work area at all times
Performs all other related duties as assigned or requested