Medical Coder II

POSITION SUMMARY

The Medical Coder II position is responsible for analyzing and interpreting medical records to ascertain medical coding, providing complete and timely diagnosis information to regulatory agencies, and reviewing data to maximize revenue within regulatory guidelines. The ideal candidate for this position will be detail oriented, have a collaborative spirit and excellent communication skills.

MISSION :

Improving lives, Optimizing wellness, Promoting independence

COMPETENCIES

Technical Expertise Problem Solving Teamwork Effective Communication Results Oriented Personal Credibility Quality Focus People Focus Flexibility

RESPONSIBILITIES AND DUTIES

ESSENTIAL

JOB FUNCTIONS

Reviews participant medical records to ensure complete and accurate information Reviews medical staff documentation to ensure consistency and completeness Extracts principal diagnosis and procedures information utilizing current Medicare coding guidelines and other supporting references Enters codes into reporting database. Codes ancillary outpatient and inpatient hospital encounters using

ICD-10 CM.

Maintains the highest percentage of accuracy as possible and monitors personal audit results from independent coding auditor Reviews coding reports to ensure ongoing diagnoses are appropriately documented and follows up with providers regarding dropped Hierarchical Condition Categories (HCC) and documentation requirements Analyzes reports for errors/irregularities and identifies root causes of error in order to prevent future coding errors Analyzes reports to monitor both favorable and unfavorable trends over time and brings the data analysis to supervisors attention for discussion and remediation Obtains and prepares data for periodic/special reports, as requested Maintains a positive and productive working relationship with coding consultant(s) in order to gain organization-specific guidance and coding knowledge Stays current in changing Medicare regulatory environment and requirements Assists Accounting staff with month-end activities, as requested Participates in projects related to year-end and other audits as needed Actively participates in Health Information Management team meetings and special projects to ensure the team successfully meets its strategic goals

ORGANIZATIONAL

(CORE

RATING FACTORS

): Demonstrates support of the Companys Mission, Vision and Core Values Provides Exceptional Customer Service Ensures discretion with confidential information in accordance with HIPAA guidelines Supports a collaborative work environment including courteous, helpful and professional behavior Embraces Organizational Excellence through practicing individual time management, efficiency and effectiveness and participating in continuous improvement efforts Adheres to and supports all Company policies and procedures Supports and practices safe work habits in accordance with policies and procedures Brings ideas, problems and concerns forward and participates in resolution and implementation Participates in and completes regulatory compliance trainings within the prescribed deadlines Attends required meetings Maintains skills and knowledge required including written and verbal communication, best practices for industry standards, and computer competency H.S. Diploma or equivalent required Minimum 7 years experience with medical coding and familiarity with medical terminology is required. Medicare and Medicaid coding experience with a working knowledge of compliance, federal and state rules and regulations required Minimum 3-5 years experience with electronic health records systems required Associates degree in a related field preferred CPC- Certified Professional Coder or CCS-P through AHIMA required within 6 months of hire Risk Management coding experience preferred We strive to provide our employees with a comprehensive and affordable benefits package including Medical and Prescription Drug, Dental, Vision Care, Wellness Program, Telemedicine Program, Flexible Spending Accounts, Health Savings Account, Company Paid Basic Life and Accidental Death & Dismemberment, Company Paid Long-Term Disability, Voluntary Life Insurance, Voluntary Short-Term Disability, Accidental Injury Insurance, Critical Illness, Hospital Indemnity, 403(b) Savings Plan, Legal Shield and IDShield, Employee Assistance Program (EAP), Paid Time-Off plan. Such benefits are based on applicable state law and factors such as pay classification (full-time, part-time, or PRN/casual), job grade and length of service.