What are the responsibilities and job description for the Coder, Certified position at Shenandoah Medical Center?
- Accurately codes and sequences diagnosis and procedures according to coding guidelines and abstract accurate clinical information for optimum reimbursement.
- Reviews documentation to determine the diagnosis and procedures performed.
- Assigns charge master codes, modifiers for appropriate billing and sequencing.
- Uses multiple information systems to accurately select the correct patient account to enter patient billable charges.
- Participates in audits to capture lost charges and determine accuracy of billing and coding.
- Maintains active contact with staff and providers on missing or inaccurate documentation.
- Maintains active contact with departments to resolve billing issues.
- Communicates and collaborates with healthcare providers/ compliance/coding on identifying changes in documentation that may lead to maximizing reimbursement.
- Demonstrates professional growth by developing personal educational objectives to maintain coding knowledge and regulatory requirements and participating in opportunities to assure continued adherence to professional standards and the provision of highest quality care.
- Plans and implements a program for continuing self-development to meet continuing education requirements for CPC, COC, CCS, CCS-P certification.
- Demonstrates organizational skills, self-motivation and flexibility in meeting personal, professional and institutional objectives.
- Maintains current knowledge of national NCCI Coding standards of practice, JCAHO/CMS, and criteria appropriate to coding and billing.
- Maintains current knowledge of changes in ICD-10 CM/PCS, CPT-4 and HCPCS. Provide feedback and education on codes that are changed or no longer appropriate for billable items.
- Organizes data to allow for identification of documentation trends to provide feedback to staff and other healthcare providers to allow for increased capture of billable items.
- Follows policies/procedures/regulatory requirements and performs other work assignments.
- Complies with all departmental and organizational policies and procedures in addition to regulatory requirements (such as OSHA, CMS, Joint Commission, etc.)
- Participates in corporate/departmental safety and quality activities.
- Performs other duties as assigned.
Preferred
- 3 - 5 years: internal auditing experience preferred
- 1 - 3 years: medical coding experience preferred (ICD-10 CM/PCS, CPT-4, HCPCS)
Required
- High School or better
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