Senior Coder - Newark, United States - Christiana Care

Description

PRIMARY FUNCTION:

Responsible for accurate and timely assignment of ICD 10 CM/PCS and HCPCS/CPT codes, payment group classification assignment and data abstraction for reimbursement purposes and statistical information reporting on all Inpatient, Outpatient, Emergency Medicine, Ancillary and Diagnostics records, and/or any other patient records for which HIMS Department performs coding services .

Meets or exceeds productivity and accuracy standards outlined in the HIMS Coding Policies and Procedures.




PRINCIPAL DUTIES AND RESPONSIBILITIES:

Reviews and interprets Inpatient, Outpatient, Ancillary, Diagnostics and Emergency Medicine or other patient type records in order to assign appropriate ICD 10 CM/PCS diagnosis and procedure codes and/or HCPCS/CPT procedure codes as required based on record type and CCHS reporting practices.

Performs coding and abstracting tasks to support accurate and timely billing, data quality and statistics, and calculation of severity of illness and risk of mortality reporting.

Follows UHDDS definitions, CMS regulations, and Official and Internal Coding Guidelines.

Utilizes information on diagnostic reports (i.e., radiology, pathology, EKG reports, laboratory values, doctors orders, and administrative medication forms) to accurately code patient charts in accordance with the Official Coding Guidelines.

Completes daily work assignment as directed by Coding Support.

Works within service line structure where applicable based on patient type.

Serves as a mentor to newer coders in the Coder Position or coders who are being trained in a new coding discipline.

Abstracts pertinent data, determines and sequences codes for diagnoses and procedures, and enters all information into the coding and abstracting system.

Utilizes coding and abstracting system as a communication tool, as outlined in the HIMS Coding DNFB Tagging procedures, including but not limited to placing accounts on hold in order to ask questions to management and initiate queries.

Receives feedback and reviews charts with a member of the Coding Management Team for accurate code assignment.

Provides all necessary coded and abstracted information required for final coding and billing of accounts within productivity expectations by work type in order to support department and organization goals for DNFB dollar amounts and bill hold days.

Reviews prepopulated patient demographic information fed via HL7 from source system into coding system and makes necessary abstracted data changes in coding system as required for accurate posting to CCHS billing system.

Utilizes coding system to calculate all inpatient encounters in both MS DRG and APR DRG groupers to support the accurate reporting of coded data for severity of illness and risk of mortality.

Utilizes coding system to sequence CPT codes invoking the APC grouper methodology to arrive at the proper CPT code hierarchy.

Submits timely, accurate, and concise daily productivity reports in accordance with department policy and practice.

Attends and participates in coding section and department meetings, inservice training sessions, seminars and workshops.

Reports errors as identified in patient identification, account or encounter information, documentation or other medical record discrepancies as they are noted during daily work performance.

Supports the Coding Management team by working on special coding projects as assigned.

Works with the HIMS Coding Systems Analyst under the direction of HIMS management to achieve the IT initiatives of the HIMS department.

This may include systems testing and report reconciliation as needed in our coding and billing systems as well as other IT project support as deemed necessary by the coding management team.

Works with the HIMS Coding Support Team under the direction of HIMS management to achieve the revenue cycle goals of the HIMS department.

This may include working through aged coding accounts, accessing our billing system, and coding system reports and queues as deemed necessary by the coding management team.

Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.

Performs other related duties as required.

SCOPE, PURPOSE,


AND FREQUENCY OF CONTACTS:


Daily contact with intradepartmental personnel. Frequent contact with clinical, ancillary, and Information Services staff. Occasional contact with physicians and physician s office staff. Occasional contact with the public

DIRECTION/


SUPERVISION OF OTHERS:


None

DIRECTION/


SUPERVISION RECEIVED:



Immediate:
Coding Supervisor; Indirect: Coding Coordinator; Associate Director Coding and Data Quality; Dept


Head:
Corporate Director, HIMS