Coder II - FT Days - Coding

DHR Health - US:TX:McAllen - Days

Summary:

POSITION SUMMARY:

This is a mid-level, work from work position. Coder is responsible for:

• Analyzing provider documentation
• Assign and sequence ICD-10-CM, CPT®/HCPCS appropriately
• Append billing modifiers when appropriate
• Reconcile CPT(s)
• Resolves billing edits according to 3M Code editor
• Participates in educational activities and attends staff meetings.

POSITION EDUCATION/ QUALIFICATIONS­ :

· Coding credential from an accredited coding organization required

· Credentials from AHIMA, AAPC preferred

· Extensive knowledge of medical terminology

· Knowledge of Coding Guidelines

· Knowledge of CPT rules and regulations

· Knowledge of NCCI policies

· Highly reliable

· Must be a team player with good people skills and possess strong initiative to get daily work finished and processed

· Maintain productivity levels

JOB KNOWLEDGE/EXPERIENCE­ :

· Extensive experience in medical coding, medical terminology, and anatomy and physiology required; 3 year of coding experience preferred

· Requires reasoning ability and good independent judgment

· Ability to perform productive research quickly

· Requires working with minimal interruptions

· Must have an understanding of laws and ethics related to health insurance, medical billing and Health insurance Portability and Accountability Act (HIPPA)

· Computer and coding software experience required, 3M encoder preferred

· Advanced computer skills required with knowledge of Microsoft Office suite Experience in Professional coding and billing a plus

Responsibilities:

POSITION RESPONSIBILITES:

· Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices

· Coding ICD-10-CM to the highest level of specificity

· Accurately Codes outpatient procedures according to CPT guidelines

· Must be able to validate CPT based on medical record documentation

· Ability to code outpatient record types such as: Ambulatory surgery, General surgery, ENT surgery, Eye/Vision surgery, Interventional Radiology, Orthopedic surgery, Cardiovascular surgery, Spinal surgery, Pediatric surgery, Stereotactic surgery, Reconstruction/Plastic, Ob/Gyn surgery, Dental surgery, ER, Observations, Radiation/Chemo Oncology, Infusions, ect…

· Queries physicians for clarification when ambiguous, vague, or incomplete information is identified

· Ability to accurately attach HCPCS Level I and Level II modifiers for billing purposes

· Utilizes computerized 3M Coding Software

· Utilizes and researches 3M Coding references for final coding

· Must be able to identify medical abbreviations, terms and their meanings

· Codes all available records in a timely a manner

· Must be able to multitask

· Meets quality standards of having ≥ 95% of charts coded accurately

· Meets productivity standards set forth by the coding manager

· Communicates with Coding Manager to solve problems and to clarify coding issues

· Assign mnemonics to unbilled accounts as appropriate

· Maintains a good working relationship within the department, other departments, and medical staff

· Assist the business office with clearing reimbursement and denial issues

· Clears AEOS in a timely manner

· Communicates via email and/or phone with other departments to obtain pertinent information in order to code the account

· Willing to transition into Inpatient coding

· Coding of introductory level Inpatient accounts may be required

· Communicates with RMF clinic management to ensure timely professional billing

· Ability to identify and accurately assign discharge/disposition status

· Must take initiative to further coding knowledge

· Attends workshops, seminars or conferences that pertain to position and that fulfill CE hour requirements

· References ICD-10-CM, CPT, and HCPCS Level II code books as needed

· Reviews Coding Clinic updates and continuing education periodicals in a timely manner

· Adheres to the Health Information Management Policies and Procedures for Coding

· Adheres to the Coding Compliance Plan

· Follows the AHIMA Standards of Ethical Coding

· Maintains confidentiality and safeguards all patient related information. Performs other duties as assigned

Other information:

LINES OF REPSONSIBILITES :

(Chain-of-command)

1. (Chief Revenue Officer) → 2. (Director of Coding) → 3. (Coding Supervisor)

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC :

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA) :

A. Essential Duties : Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

· Light/moderate lifting up to 20 lbs, from the floor to shoulder height.

· Yes

· Kneeling

· Yes

· Must be able to assist other employees with lifting more than 20 lbs.

· Yes

· Walking

· Yes

· Light/moderate carrying up to 20 lbs.

· Yes

· Standing/Squatting

· Yes

· Straight pulling

· Yes

· Sitting

· Yes

· Pulling hand over hand

· Yes

· Pushing

· Yes

· Repeated bending

· Yes

· Stooping/Bending

· Yes

· Reaching above shoulder

· Yes

· Climbing Stairs

· Yes

· Simple grasping

· Yes

· Climbing Ladders

· No

· Dual simultaneous grasping

· Yes

· Depth Perceptions needed

· Yes

· Ability to see

· Yes

· Identify Colors

· Yes

· Operating office equipment

· Yes

· Twisting

· Yes

· Operating mechanical equipment

· Yes

· Crawling

· No

· Ability to read and write

· Yes

· Ability to Count

· Yes

· Ability to hear verbal communication without aid

· Yes

· Operating Personal Vehicle

· Yes

· Ability to comprehend written/verbal communication

· Yes

· Other: Ability to deal with stress

· Yes

· OSHA Category

· III

·

·

B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes: HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________

Transfer/Hire Date Effective: ________________________.