• Conifer Health Solutions
  • Manville , RI
  • Miscellaneous
  • Full-Time
  • 46 Reservoir Rd


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JOB SUMMARY

Responsiblefor assigning diagnostic and procedural codes to patient charts of moderate tohigh complexity using ICD-10-CM, CPT and HCPCS or any other designated codingclassification system in accordance with coding rules and regulations. Respondsto audits, conducts coding or provides consultation on projects, and may be theprimary point of contact to CDI team when coding supervisor/manager is notavailable. Mentors staff and assistswith questions. Abides by the Standardsof Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record.

ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned.

Coding: Reviewsmedical records for the determination of accurate assignment of all documenteddiagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA).

Abstracting: Reviews medical records to determine accurate required abstractingelements (facility/client specific elements) including appropriate discharge disposition.

Coding Quality: Demonstrates ability to achieve accuracy andconsistency in the selection of principal and secondary diagnoses (includingMCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstractingelements defined by per facility.

Goal: Average coding quality standard of => 95 curacy per monitoring period.

Does not meet =<95 curacy

Meets => 95 curacy

Exceeds => 95.01 curacy

Coding Labor Productivity: Meets and/or exceeds Conifer s coding productivityguidelines.

Professional Development: Stays current with AHA Official Coding andReporting Guidelines, CMS and other agency directives for ICD-10-CM and CPTcoding. Attends mandatory codingseminars on annual basis (IPPS and OPPS, ICD-10-CM and CPT updates) forinpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls

Communicatesand resolves coding issues (lacking documentation, physician queries, etc.) forappropriate follow-up and resolution


Qualifications

: KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individualmust be able to perform each essential duty satisfactorily. The requirementslisted below are representative of the knowledge, skill and/or abilityrequired. Reasonable accommodations may be made to enable individuals withdisabilities to perform the essential functions.

  • Knowledgeof MS-DRG classification and reimbursement structures

  • Understandingof appropriate level of care orders

  • Workingknowledge of Value Based Purchasing (VBP)

  • Proficientat writing AHIMA complaint physician queries

  • Adeptat comparing documentation, code assignment and charge in the financial systemfor accuracy and completeness and elevating concerns to the appropriate manager

  • Proficientin researching and responding to Business Office questions and/or question bythe payer

  • Abilityto mentor less experienced staff in all areas of coding. Assists in the training of new andtransitioning coding staff

  • Abilityto establish and maintain effective working relationships as required by theduties of the position

  • Abilityto concentrate and accomplish tasks with explicit accuracy

  • Abilityto use office equipment and automated systems/applications/software at anacceptable level of proficiency

  • Functionalknowledge of facility EMR, encoder and other support software

  • EDUCATION / EXPERIENCE

    Include minimum education, technical training,and/or experience preferred to perform the job.

  • Threeto five years experience performing medical record coding in acute caresetting required.

  • Highschool graduate or equivalent is required.

  • Associateor Bachelor s Degree in Health Information, Nursing, or other related field, orformal coding classes completed and passed preferred. Years of coding experience would beconsidered in lieu of educational requirements.

  • CERTIFICATES, LICENSES, REGISTRATIONS
  • Required: AHIMA or AAPC approved credential
  • PHYSICAL DEMANDS

    The physical demands described here arerepresentative of those that must be met by an employee to successfully performthe essential functions of this job. Reasonable accommodations may be made toenable individuals with disabilities to perform the essential functions.

  • Mustbe able to work in sitting position, use computer and answer telephone

  • Abilityto travel

  • Includesability to walk through hospital-based departments across broad campussettings, including Emergency Department environments




  • * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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