About This Role
This Coder I position is responsible for accurate coding, abstracting, claims filing, documentation review, and claims denial processing using appropriate medical record documentation. The role requires staying current on code changes and coding guidelines to ensure quality and compliance. The Coder also handles data quality and insurance representative functions, collaborating closely with the HIMS department.
Responsibilities
- Review inpatient and outpatient medical records to identify the principal diagnosis and all applicable secondary diagnoses and procedures
- Use a computerized encoding system to facilitate accurate coding according to the appropriate classification system
- Sequence diagnoses and procedures by following ICD-10-CM & ICD-10-PCS, CPT/HCPCS, UHDDS, Medicare, Medicaid, and other fiscal intermediary guidelines
- Be cross-trained to assist with backlog in any needed focus-coding group
- Work cooperatively with medical staff and other healthcare professionals in obtaining documentation to ensure optimal hospital payment and accurate data input
- Prepare workload reports and participate in department continuous quality improvement studies
- Abstract medical data from the record to complete discharge data abstract on each outpatient
- Complete and verify diagnostic, demographic, and other information for submission to KHDS
- Review, verify, and initiate necessary correction processes for data quality review
- Participate in medical record documentation auditing to monitor physician compliance with regulatory requirements
- Communicate and advise other hospital personnel on coding and DRG assignment
- Meet established quality and productivity standards
- Adhere to all hospital and departmental policies, procedures, and regulations, including attendance
- Perform other related duties as assigned or requested
- Concentrate and maintain accuracy in spite of frequent interruptions and/or distractions, sit for long periods
- Follow instructions and use sound judgment
- Maintain close mental and visual attention to details, as well as excellent verbal and written communication skills
- Handle frustration and interactions with others in a professional manner
- Be self-motivated to complete work assignments in a timely, accurate manner
- Maintain ongoing registration and continuing education for applicable credentials
- Perform other duties as needed or assigned
- Maintain regular and reliable attendance
Requirements
- High School Diploma or equivalent
- Completion of one of the following through AHIMA accredited programs: Certificate Coding Associate, Certificate Coding Specialist, Certified Professional Coder, Registered Health Information Technician, Registered Health Information Administrator OR
