Coder II

EQUAL EMPLOYMENT OPPORTUNITY

• Race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate shall not be a factor in employment for this position. Due to the nature of hospital services, it may become necessary to work extended hours.

POSITION SUMMARY

• This position is responsible for accurately coding accounts from at least one main outpatient work type (Observation, Same Day Surgery, and/or ER) as well as assisting with the coding of other outpatient work types as needed. All accounts should be completed within three (3) days following discharge.

POSITION SUPERVISORY RESPONSIBILITIES

• Reports To:
• HIM Coding Manager
• Supervises:
• None

POSITION REQUIREMENTS

• Minimum Education
• Completion of college level course work in Medical Terminology and Anatomy and Physiology.
• Minimum Work Experience
• Required: A minimum of two (2) years coding experience in an acute care hospital.
• Required Licenses/Certifications
• CCA credentials (Certified Coding Associate) or CPC credentials (Certified Professional Coder)
• Required Skills, Knowledge, and Abilities
• Completion of college level course work in Medical Terminology and Anatomy and Physiology.
• Preferred Qualification
• CCS credentials (Certified Coding Specialist -- Hospital based)
• RHIT or RHIA credentials
• Minimum education level of Associates Degree.

PHYSICAL REQUIREMENTS

• Will work remotely from home; must reside in the state of Texas.
• Must be able to work in a virtual setting.
• Primarily sedentary work reviewing records and keying information using a computer monitor and keyboard.
• Quiet surrounding with adequate lighting.

 

QUALITY BEHAVIORAL EXPECTATIONS

• Generally and in all job specific duties: Uses critical thinking skills to determine evidence based solutions. Systematically gathers and reviews pertinent information to prevent errors (PDCA -- Plan, Do, Check, Act). Pursues individual or team learning and growth opportunities to continually build skills. Understands and abides by all safety regulations.

 

SERVICE EXCELLENCE BEHAVIORAL EXPECTATIONS

• Generally and in all job specific duties: Maintains patient confidentiality. Rounds regularly with patients, direct reports and/or customers. Uses telephone and elevator etiquette. Acts as an employee ambassador. Committed to know hospital service lines and shows pride in our organization. Uses AIDET when dealing with internal or external customers.

 

FISCAL RESPONSIBILITY BEHAVIORAL EXPECTATIONS

• Generally and in all job specific duties: Takes responsibility for solving problems. Treats company resources responsibly. Performs work functions timely and accurately. Respects our environment; keeps public areas neat and clean and returns supplies to the appropriate areas.

 

PEOPLE BEHAVIORAL EXPECTATIONS

• Generally and in all job specific duties: Supports the team through good attendance. Maintains a professional appearance. Creates a positive team environment; flexible and supportive setting an example of cooperation. Uses meaningful communication; provides honest feedback that is valuable and not critical and discourages negative talk and gossip. Respect co-workers.

 

JOB SPECIFIC FUNCTIONS

1. Demonstrates an understanding of and adherence to the HMHD Compliance Plan.

1. Conduct reflects HMHD's values and a commitment to HMHD's Code of Conduct.
2. Attends the required corporate integrity and compliance training and education programs.
3. Demonstrates proficiency in understanding the materials presented during the corporate integrity and compliance training and education program.
4. Complies with all HIPAA standards.
5. Consistently meets monthly productivity expectations.
6. Responsible for final coding of outpatient accounts (Observation, Same Day Surgery and/or Emergency Department) with an average turnaround time of three (3) business days.
7. Responsible for accurately assigning ICD-10-CM and applicable CPT codes based on information provided in the patient record, while maintaining an overall coding accuracy rate of 95% or greater.
8. Responsible for responding to any audited accounts within three (3) business days of receipt.
9. For ER accounts, responsible for capturing procedure charges as applicable.
10. For observation accounts, responsible for capturing ER E/M level charges, applicable procedure charges, injections/infusions charges, and observation hour charges for patients that are admitted to observation.
11. Works with Clinical Documentation Improvement (CDI) to prompt medical staff physicians for additional documentation as needed to clarify correct assignment of ICD-10-CM diagnosis and CPT procedure code assignment.
12. Responsible for responding to Patient Financial Services (PFS) questions regarding coding assignments that generate errors within the billing editor within three (3) business days of receipt.
13. Responsible for completing continuing education requirements to maintain coding credential. Must obtain a minimum of ten (10) continuing education units per year.
14. Assists with other special projects as requested by the HIM Coding Manager and/or the HIM Department Director.