Senior Coder

Bon Secours - Valhalla, NY

Full-time - Mid Level

Valhalla, NY

Nursing and Residential Care Facilities

About the position

The Senior Coder is responsible for coding complex medical records and addressing appeals to insurance companies. This role requires expertise in various coding systems and guidelines, as well as the ability to provide technical guidance and lead lower-level coders. The position plays a crucial role in ensuring accurate coding for diagnoses and procedures, facilitating reimbursement processes, and maintaining compliance with coding standards.

Responsibilities

• Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.
• Interprets and applies American Hospital Association Official Coding guidelines to articulate and support principal and secondary diagnoses and selected procedures.
• Identifies and analyzes patterns in possible coding errors or other trends and reports to the Supervising Medical Records Coder.
• Participates in mandated medical record review processes.
• Assigns and records an accurate code to all diagnoses, procedures, and operations using current HCPCS, ICD, and CPT coding systems.
• Ensures that all factors necessary for assigning an accurate DRG are present, and that all diagnoses are ranked properly.
• Makes appropriate contacts to acquire or clarify necessary information.
• Enters final diagnostic code numbers and narrative descriptions of diagnoses and procedures into an automated grouper system.
• Compiles and updates the appeal log detailing denials, hospital's reply and follow-up responses.
• Provides information and responds to inquiries regarding medical documentation and DRGs to hospital staff.
• Abstracts information from medical records to compile reports and statistical information.
• Enters data such as diagnosis, treatment, admission and discharge dates, and length of stay on hospital-wide or regional automated database.
• May train lower level coders and provide technical guidance and expertise.

Requirements

• 6 years of experience in medical records coding, with 4 years within the last 5 years and 2 years involving coding emergency room or trauma cases.
• High School diploma or equivalent required.
• Satisfactory completion of 30 credits toward an Associate's or Bachelor's degree in health information management may substitute for up to 4 years of general coding experience.
• Current certification as either a Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician Based (CCS-P) through AHIMA, or as a Certified Professional Coder (CPC) through the American Academy of Professional Coders.

Nice-to-haves

• Certification as Registered Health Information Administrator (RHIA) or Registered Health Information Technologist (RHIT) by the American Health Information Management Association.

Benefits

• Health Insurance
• Dental
• Vision
• Retirement Savings Plan
• Flexible Savings Account
• Paid Time Off
• Holidays
• Tuition Reimbursement