PB Coder – Hours/week

PB Coder – Hours/week

Requirements

• HS Diploma and 2 years of experience, or
• Associate’s degree in Coding (or similar field)—no experience required
• Working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping and components of charge description master for charging functions and understanding when to use the appropriate modifiers.
• Must possess knowledge of third-party reimbursement regulations and billing practices.
• Experience utilizing encoding/grouping software.
• Ability to use standard desktop and windows-based computer system, including basic understanding of email, internet, and computer navigation.
• High ethical standards.
• Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines.
• Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters.
• Knowledge of hospital and professional coding including provider-based billing.
• Knowledge of documentation regulations of Joint Commission and CMS.
• Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices.
• Experience in assisting and identifying learning needs as well as providing training to coding staff.
• Strong analytical abilities and problem-solving skills.
• Excellent oral, written and interpersonal communication skills.
• Ability to organize and set priorities to ensure objectives are met in a timely manner.
• Ability to adapt to change and handle challenges proactively and with pose.
• Ability to effectively collaborate with physicians and managerial staff at all levels.

Responsibilities

• Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers.
• Validates charges by comparing charges with health record documentation as necessary.
• Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
• Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems.
• Tracks issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion.
• Consistently meets coding quality and productivity standards established by coding department.
• Adheres to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information.
• Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
• Performs other duties as assigned by leadership.
• Maintains working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Preferred Qualifications

• It is preferred that the coder have one or more of the following certifications:
• Certified Professional Coder from the American Academy of Professional Coders (AAPC)
• Certified Outpatient Coder from the American Academy of Professional Coders (AAPC)
• Certified Inpatient Coder from the American Academy of Professional Coders (AAPC)
• Certified Professional Coder – Payer from the American Academy of Professional Coders (AAPC)
• Certified Risk Adjustment Coder from the American Academy of Professional Coders (AAPC)
• Certified Coding Associate from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA
• Preferred: Registered Health Information Technician from the Commission on Certification for Health Informatics and Information Management (CCHIIM)
• Certified Coding Specialist from the Commission on Certification for Health Informatics and Information Management (CCHIIM)