HIM Operations-Specialist I

The job description reflects the general details considered necessary to fulfill the essential job functions and shall not be construed as a detailed description of all work requirements inherent in this position. Other specific job-related knowledge and skills may be required.

1. Financial/Coding.  Codes outpatient surgery, therapy, observation, ER, and ancillary records following accepted coding guidelines, correct coding initiatives, standards of ethical coding and policies and procedures.  May also code inpatient, and swing bed records, as indicated.  Assures appropriate documentation is available for complete and accurate coding.  Queries provider or appropriate staff for coding clarification as required and obtains necessary documentation as indicated.  Checks for medical necessity for required tests and codes based on documentation in the record. Verifies APC's.  May perform coding audits on occasion.  Works coding backlog reports as required to keep coding backlog to a minimum.  Routes charts to appropriate locations and logs chart location in CPSI if indicated.  Accesses eCw for coding clarification / medical necessity concerns.                                                                                                                                              
2. HIPAA / Compliance.  Maintains coding certification.  Compliant with requirements for continuing education.  Safeguards confidentiality. Follows coding guidelines, correct coding initiatives, standards of ethical coding and policies and procedures.  Follows HIPAA, compliance and all organizational policies.                                                                                                                                                                                    
3. Communications.  Answers phone promptly with a friendly, professional tone.  Communicates with visitors, co-workers and medical staff in a friendly, professional manner. Respectful to all.                                                                                                                                                                                         
4. General Departmental Functions.  General knowledge of HIM departmental functions.  Attends mandatory and other pertinent inservices as well as educational inservices to maintain credentials & competency.  May cover for charge specialist if indicated.  Embodies OCH values.  Knowledge of Policy Tech and Common Share.   Other duties as assigned.   
5. Frequently accesses email to stay up to date on information within the organization and provides a way of communication between staff members. 
6. May be requested to be member of QI team.