Senior HB Coder - Remote

LCMC Health

74d

About The Position

The Coding Senior will be responsible for applying the appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determining the MS-DRG and APR-DRG assignment of inpatient records across multiple specialties (cardiology, cardiothoracic surgery, trauma, orthopedics, general medicine and surgery, pediatrics, obstetrics, newborns, etc.) or applying the appropriate ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties (i.e. family medicine, internal medicine, cardiology [IR], cardiothoracic surgery, interventional radiology, trauma, orthopedics, general surgery, urology, gynecology, etc.). The Coding Senior may be assigned any of the coding functions of a Coding Specialist I. Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs assignment and all required modifiers. Validates charges by comparing charges with health record documentation as necessary. Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems. Tracks issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion. Consistently meets or exceeds coding quality and productivity standards established by coding department. Adheres to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information. Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations. Performs other duties as assigned by leadership. Maintains working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Requirements

• High School Diploma/GED or equivalent and 3 years of work experience, or Associate’s and 1 year of experience, or Diploma/Certification in Coding and 1 year of experience.
• Comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding.
• Knowledge of third party reimbursement regulations and billing practices.
• Experience utilizing encoding/grouping software.
• Ability to use standard desktop and windows based computer systems.
• Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS coding principles and guidelines.
• Experience in ICD-10-CM/PCS coding and reimbursement training.
• Knowledge of Prospective Payment System (PPS) methodology.
• Knowledge of documentation regulations of Joint Commission and CMS.
• Experience with concurrent coding reviews.
• Knowledge of privacy and security regulations.

Nice To Haves

• Associate's Degree in HIM or similar.
• Completion of AHIMA Approved coding program or AAPC coding program.
• Registered Health Information Technician certification.
• Registered Health Information Administrator certification.
• Certified Coding Specialist certification.

Responsibilities

• Apply appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes.
• Determine MS-DRG and APR-DRG assignment of inpatient records across multiple specialties.
• Apply appropriate ICD-10 diagnostic and CPT procedure codes for ambulatory records.
• Navigate patient health records and computer systems to determine diagnosis and procedure codes.
• Validate charges by comparing with health record documentation.
• Communicate with clinical staff, physicians, and office staff regarding documentation issues.
• Identify concerns and notify leadership for resolution.
• Provide resolution to moderate to complex problems.
• Track issues requiring follow-up to facilitate timely coding.
• Meet or exceed coding quality and productivity standards.
• Adhere to confidentiality requirements regarding patient information.
• Maintain knowledge of changes in coding and reimbursement guidelines.
• Perform other duties as assigned by leadership.

Benefits

• Equal opportunity employer.
• Commitment to community and healthcare excellence.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 501-1,000 employees