Summary:
Reports to the Manager of Hospital Coding for Lifespan Corporate Services.Under general supervision and within Hospital and departmental policy ensures accurate coding and data quality creates consistency and efficiency in inpatient services through ongoing performance of ICD-10-CM and ICD-10-PCS coding validation and accurate Medical Severity (MS) Diagnosis Related Groups and APR-DRG All Patient Related Groups. Responsible for providing training to staff on ICD-10-CM and ICD-10-PCS coding in accordance with Official Coding guidelines.
Responsibilities:
Performs coding quality reviews on inpatient records to validate the ICD-10-CM /PCS codes DRG group appropriateness missed secondary diagnoses and procedures and ensures compliance with all DRG mandates and reporting requirements. Ensures the medical record documentation supports the codes selected for the principal diagnosis secondary diagnoses complications co-morbid conditions procedures and discharge disposition that impact the DRG assignment.
Performs retrospective coding audits as required. Reviews and responds to third party payment audit denial in a timely manner. Review inpatient coder questions on complex cases. Reviews and amends coding physician queries for appropriateness and accuracy prior to submission for complex clinical scenarios.
Continuously evaluates the quality of the clinical documentation to spot incomplete or inconsistent documentation for inpatient hospital stays that impact code selection and resulting DRG groups and payments.Brings identified concerns to department management for resolution.
Serves as lead trainer for inpatient coding staff. Consults and collaborates with management regarding coding training and education.Provides training for coding staff and educates facility healthcare professionals in the use of coding guidelines and practices proper documentation techniques coding terminology and disease processes as it relates to the MS DRG/ APR DRG assignment.Adapts training programs to adjust to changes mandated by regulatory updates. Maintains knowledge of current professional coding certification requirements and keeps current of coding updates.
Prepares reports from the SMART Coding Validation System on coder accuracy sharing with manager any identified trends requiring coder education when needed
May be required to cods inpatient charts if needed.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and monitors coding staff for violations and reports to Coding Manager when areas of concern are identified.
Other information:
BASIC KNOWLEDGE:
Associate degree in health information technology preferably with Registered Health Information Technicians (RIHT) and/or successful completion of coding certification program.Understanding of the content of the medical record. Certified Coding Specialist certification required. (AHIMA preferred).
Ability to recognize and understand clinical documentation pertinent for coding including clinical indicators risk factors and treatments for diagnoses.
Trained in medical terminology medical science disease processes anatomy and physiology.
Computer literate: capable of researching websites to access regulatory requirements.
Ability to navigate the patient electronic medical record.
Strong writing organizational and communication skills required.
EXPERIENCE:
Five years inpatient coding experience in an acute care facility.
Auditing experience and/or strong training background in coding preferred.
WORKING CONDITION AND PHYSICAL REQUIREMENTS:
Requires long periods of sitting to review medical records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy.
On site office or home office environnent.
All staff working remotely must adhere by the Flexible Work Arrangements Policy and follow the Flexible Work Arrangements Guidelines and Forms instructions.
INDEPENDENT ACTION:
Performs independently within the department�s policies and procedures. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required.
SUPERVISORY RESPONSIBILITY:
None.
Corporate Headquarters
Providence Rhode Island
United States
None
(No Timezone Provided)
Summary:
Reports to the Manager of Hospital Coding for Lifespan Corporate Services.Under general supervision and within Hospital and departmental policy ensures accurate coding and data quality creates consistency and efficiency in inpatient services through ongoing performance of ICD-10-CM and ICD-10-PCS coding validation and accurate Medical Severity (MS) Diagnosis Related Groups and APR-DRG All Patient Related Groups. Responsible for providing training to staff on ICD-10-CM and ICD-10-PCS coding in accordance with Official Coding guidelines.
Responsibilities:
Performs coding quality reviews on inpatient records to validate the ICD-10-CM /PCS codes DRG group appropriateness missed secondary diagnoses and procedures and ensures compliance with all DRG mandates and reporting requirements. Ensures the medical record documentation supports the codes selected for the principal diagnosis secondary diagnoses complications co-morbid conditions procedures and discharge disposition that impact the DRG assignment.
Performs retrospective coding audits as required. Reviews and responds to third party payment audit denial in a timely manner. Review inpatient coder questions on complex cases. Reviews and amends coding physician queries for appropriateness and accuracy prior to submission for complex clinical scenarios.
Continuously evaluates the quality of the clinical documentation to spot incomplete or inconsistent documentation for inpatient hospital stays that impact code selection and resulting DRG groups and payments.Brings identified concerns to department management for resolution.
Serves as lead trainer for inpatient coding staff. Consults and collaborates with management regarding coding training and education.Provides training for coding staff and educates facility healthcare professionals in the use of coding guidelines and practices proper documentation techniques coding terminology and disease processes as it relates to the MS DRG/ APR DRG assignment.Adapts training programs to adjust to changes mandated by regulatory updates. Maintains knowledge of current professional coding certification requirements and keeps current of coding updates.
Prepares reports from the SMART Coding Validation System on coder accuracy sharing with manager any identified trends requiring coder education when needed
May be required to cods inpatient charts if needed.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and monitors coding staff for violations and reports to Coding Manager when areas of concern are identified.
Other information:
BASIC KNOWLEDGE:
Associate degree in health information technology preferably with Registered Health Information Technicians (RIHT) and/or successful completion of coding certification program.Understanding of the content of the medical record. Certified Coding Specialist certification required. (AHIMA preferred).
Ability to recognize and understand clinical documentation pertinent for coding including clinical indicators risk factors and treatments for diagnoses.
Trained in medical terminology medical science disease processes anatomy and physiology.
Computer literate: capable of researching websites to access regulatory requirements.
Ability to navigate the patient electronic medical record.
Strong writing organizational and communication skills required.
EXPERIENCE:
Five years inpatient coding experience in an acute care facility.
Auditing experience and/or strong training background in coding preferred.
WORKING CONDITION AND PHYSICAL REQUIREMENTS:
Requires long periods of sitting to review medical records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy.
On site office or home office environnent.
All staff working remotely must adhere by the Flexible Work Arrangements Policy and follow the Flexible Work Arrangements Guidelines and Forms instructions.
INDEPENDENT ACTION:
Performs independently within the department�s policies and procedures. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required.
SUPERVISORY RESPONSIBILITY:
None.