Coder II - PFS CC Clinics - Sharp Corporate - Day Shift - Full Time

Hours:

Shift Start Time:

Shift End Time:

AWS Hours Requirement:

Additional Shift Information:

Weekend Requirements:

On-Call Required:

Hourly Pay Range (Minimum - Midpoint - Maximum):

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. 

What You Will Do
Responsible for coding and abstracting medical information for Physician Clinical Services in the Sharp HealthCare system. Evaluate and report on trends for accuracy of billing processes. Supports the implementation of correct coding standards as set by the department in compliance with Sharp HealthCare coding guidelines.

Required Qualifications

• Other Education as required for Physician Coding certification or formal coding training
• 1 Year Coding in a Physician Office and/or Clinical Environment.

Preferred Qualifications

• Certified Procedural Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC) -PREFERRED
• Certified Professional Coder (CPC) - AAPC -PREFERRED

Essential Functions

• Abstracting accuracy
  Demonstrates a high level of abstracting accuracy during quarterly review, peer reviews, and focused studies.
  Verifies the accuracy of interfaced data in abstracts from other applications (i.e. admissions, patient type) and edits when necessary to assure correct information.
  Assigns appropriate physician profiles as defined by medical staff policies.
• Billable code assignments
  Codes according to ICD-9CM and CPT 4 conventions and Sharp HealthCare coding guidelines.
  Refuses to fraudulently maximize reimbursement by assigning codes that do not conform to approved coding principles and guidelines.
  Refuses to unfairly maximize reimbursement by unbundling services and codes that do not conform to CPT basic coding principles.
  Uses the HCFA Common Procedural Coding System (HCPCS) to appropriately assign HCPCS codes for outpatient Medicare reimbursement.
  Abide by all ethical and professional standards (i.e. CPT/ AHIMA coding ethics).
• Coding accuracy
  Demonstrates a high level of coding accuracy during quarterly review, peer reviews, focused studies.
  Reviews clinical information and assigns/sequences the correct principle and secondary diagnoses and procedures according to CPT, ICD and CCI rule.
  Correctly identifies and assigns co morbid and/or complication codes (cc's) to obtain the accurate severity level.
  Assures that documentation is present to substantiate the codes and produce a correct final bill.
  Apply knowledge of the Ambulatory Payment Classifications to confirm APC assignment, which ensures optimal reimbursement.
  Utilizes the 3M encoder to insure that all appropriate codes are captured.
  Uses Code Correct, HCPCS, ICD-9/ICD-10, and CPT coding tools for accurate and optimal reimbursement.
  Participate in job related conferences, seminars and workshops.
  Review of various coding publications for changes and relay information to pertinent parties.
• Confidentiality
  Observes and respects the confidentiality of information in regard to patients, physician and fellow employees as stated in the policy manual.
  Follow established guidelines for release of information.
• Principle diagnosis coding
  Contacts and interacts with physicians and hospital staff as needed to clarify and assure the proper code assignments.
  For episodes of care in which determination of principle diagnosis is not clear because the patient has multiple problems, the attending physician shall be queried.
  Apply knowledge of the PPS to confirm APC assignment, which ensures optimal reimbursement.
• Productivity
  
  Meets entity specific departmental and medical group productivity standards. (SHC productivity standards are based on the DNFB average monthly goal.)
  Has knowledge and understanding of level from medical records.
  Meets ETM Productivity goals as set by the department.
  Assist in reviewing and interpreting trends and variances requiring Manager Business Services and /or Manager of Quality Control's attention. Provide coding review in support of PFS/CCD teams.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

Salary : $29 - $37