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CH
Covenant HealthCare
OUTPATIENT CODER (OCCASIONAL ONSITE REQUIRED)
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What they do
A Medical Coder organizes and reviews patient medical records and assigns codes for each diagnosis and treatment. Prepares coded information for use by health care insurers or for research. May retrieve information for clinicians and billing offices. Works in healthcare facilities.
$62,245 / year median in Michigan
-12% projected decline
Job Description
The Health Information Management Coding Specialist Outpatient provides timely and accurate clinical and administration data to ensure optimal reimbursement for facility outpatient, ambulatory surgery, observation, recurring accounts to support the facility coding needs. This may include coverage on some Rehab or Skilled Care accounts. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adhere to coding rules for outpatient coding, APC assignment, outpatient coding CCI edits and other to ensure quality coding based upon documentation with the patient record. May also code skilled care or rehab services with involves CMG assignment and IRFPAI completion. Follows policies, procedures, and guidelines to assure consistent coding quality. At the same time, utilizes analytical skills when reviewing charts, interpreting documentation, and applying codes, sufficing edits, reviewing pertinent charges, etc. Assures coding is completed timely and all work queues are maintained at a reasonable completion rate/turnaround timeframe. This includes the willingness to help others, accepting help from others and the ability to work extra when backlogs occur. Participates in HIM department meetings and area specific meetings (OPC, charge master, clinical areas, resident/physician meetings, etc.) as required. Assist in achieving departmental, AR and area specific goals. May also be required to work with external vendors/customers on issues, audits, or projects. Helps to identify solutions to problems and assists in resolving issues. Participates in identifying lean opportunities to enhance coding efficiency and lower AR. Shares knowledge during training of new staff and is a resource to others. Independent learning with desire for continued personal and professional growth. Stays current on coding updates such as Coding Clinics, code updates/changes. Utilizes numerous references to support technical decisions, clinical understanding of disease processes or procedures/tests performed. Maintains professional credentials. Assist CBO/Finance/Data/CMG/Patient Safety and Quality/Other as requested for follow up on items related to coding, billing, reimbursement. Assure that all legal requirements, including Federal (HIPAA) and State regulations are followed. Demonstrates an awareness of legal/confidentiality issues and adheres to all HIPAA Privacy and Security and department policies and procedures. Participates in the development and attainment of department and workgroup goals. Performs other duties as assigned which may include reviewing, analyzing coding denials, denial appeals, denial entry, writing appeal letters to outside agencies, coding quality reviews, training of new staff, mentoring students, or testing for new software upgrades. Help develop or maintain guidelines, procedures, or policies.