Job Description
JOB SUMMARY
The Inpatient, Outpatient/ER, or Clinic Coder codes all hospital and clinic discharged records of Medicare, Champus, Medicaid, Commercial Insurance and self pay patients for reimbursement and research in compliance with federal regulations, using ICD-9-CM, ICD-10-CM, ICD-10-PCS, and CPT-4/HCPCS classifications.
Job Requirements
JOB REQUIREMENTS
Minimum Education
- Must possess a high school diploma or equivalent.
Minimum Work Experience
- Two years previous coding experience preferred and/or credentialing as an RHIT, RHIA, CCS, CPC, or CPC-H.
- Must have knowledge of ICD-9-CM, ICD-10-CM, CPT-4/HCPS, CPT-4/HCPCS coding guidelines, medical terminology, anatomy, physiology and excellent computer skills.
FUNCTIONAL DEMANDS
Physical Requirements
Sitting - =>32%
Walking - 1-15%
Standing - 1-15%
Bending/Squatting - 1-15%
Climbing/Kneeling - 1-15%
Twisting - 1-15%
Visual and Hearing Requirements
Must be able to see with corrective eye wear if needed.
Must be able to hear clearly with assistance if needed.
Physical/Environmental requirements
Lifting - 0 -50 lbs, 50 or more with assistance
Carrying - 0- 50 lbs, 50 or more with assistance
Pulling - Up to 100 lbs
Pushing - Up to 100 lbs
OSHA
Minimal potential for direct exposure
LEADERSHIP CAPABILITIES
Mission, Service and Values
Supports the hospital Mission, Service, and Values
ESSENTIAL FUNCTIONS
Essential Functions
- Accurately codes and abstracts all medical records.
- Monitors Discharged Not Final Billed (DNFB) accounts. all medical records should be coded within 6 days of patient discharge.
- Performs chart audits on clinic records and educates physicians as needed.
- Pays close attention to documentation in the record to support medical necessity of tests performed. Checks
- Local Coverage Determinations to assure medical necessity.
- Checks National Correct Coding Initiative edits to sure that appropriate modifiers are applied to CPT/HCPCS codes when necessary.
- Works with physicians regarding diagnoses and documentation in the medical record.
- Promptly and fully investigates all complaints and/or problems through own action or referral to the to a Supervisor.
- Reports any errors or corrections that need to be made in the medical record to the HIM Department so they can be corrected in the Soarian EDM system.
- Acknowledge and work all Soarian Financials worklists (Charge Error Work List, Bill Error Cube, and Enhanced Worklists, etc.) on a daily basis.
- Assist with all other duties as assigned.
ORGANIZATIONAL EXPECTATIONS
T.J Pledge
I Will Show Compassion
-see all patients, family members, coworkers, physicians, and anyone else at T.J. as my customer.
-recognize that each and every interaction I have at T.J. Regional Health matters
-show kindness and compassion towards my customers at all times
-be sensitive to the personal and private needs of every customer
I Will Cooperate With Others
-maintain zero tolerance for abusive behavior
-listen and be willing to accept fault when I make a mistake
-never underestimate the power of an apology
-refrain from blame and judgment
-bring a sense of calm to stressful situations
I Will Collaborate With Others
-value myself and every coworker as an equal part of one GREAT team working together
-treat others in a way that I would like to be treated
-participate only in conversations that are courteous, respectful, and reflect positively on my teammates and T.J. Regional Health
-foster a calm and pleasant atmosphere, and refrain from gossip, rumors, and insults
-speak honestly, seek truth, and act with integrity towards my teammates
-value the uniqueness and expertise that each team member contributes to the whole
-meet the need of the moment, regardless of whether or not it is considered part of my job
I Will Communicate
-smile - at everyone
-always introduce myself, my role, and my purpose use body language, eye contact, and tone of voice that shows respect in every interaction
-follow the 10/5 rule: always acknowledging people at 10 feet away with a smile and always greeting people at 5 feet away
-escort any customer in need (visitors, patients) to their destination
I Will Adapt To Change
-be a part of the solution when I am presented with a challenge
-embrace change and set the example for those around me
-accept openly when there are changes that T.J. Regional and/or I have no control over
-manage the expectations of others by explaining duration and next steps as often as needed
I Will Be A Champion
-serve with passion
-view myself as an owner of T.J. Regional Health and act accordingly
-take responsibility for the physical appearance of T.J. Regional Health, including my work area
-go out of my way to daily thank and compliment my customers and coworkers
-dare to make a difference and be exceptional
-constantly try to improve myself and T.J. Regional Health
-speak positively about T.J. Regional, while at work and in public places outside of work