This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Coder 3 electronically records, stores, and reports on reams of data. Responsible for coding the following service types, based on department and assignments:

• Facility HIM: Inpatient, outpatient, emergency room, and outpatient clinical.
• Ambulatory: Coding and auditing professional inpatient, outpatient, emergency and clinic.

Coders will need to apply a broad knowledge of procedure coding, diagnosis coding, medical terminology and anatomy/physiology.

• Hospital Coder Proficiency: ICD-10 PCS/DRG/CPT/HCPCS/ICD-10 CM.
• Professional Coder Proficiency: CPT/HCPCS/ICD-10/CM.

Responsibilities

Communication

• Works in collaboration with physicians, in tracking un-coded charts and identifying opportunities to properly complete coding assignments.
• Works closely with Clinical Documentation Improvement (CDI) specialists, providers and clinical staff to develop and maintain a comprehensive audit and management system to ensure proper charge capture, sufficient documentation and proper code assignment across all service lines.
• Mentors and trains other coders in the department.
• Ambulatory/Professional Team Only: Communicates coding/documentation education and training to providers, staff and leadership.

Data integrity

• Review medical record to abstract proper code assignment.
• Assign ICD-10 CM/PCS/CPT and HCPCS codes to inpatient, outpatient, emergency room, outpatient clinical and professional services, as required.
• Apply accurate procedure coding, diagnosis coding, medical terminology, anatomy/physiology, and industry regulations.
• Assist in maintenance of medical record integrity/documentation improvement opportunities.
• Ambulatory/Professional Team Only: Develops educational material based on coding changes, code updates and audit findings, as required.

Compliance/Safety

• Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
• Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.
• If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.
• Completes all company mandatory modules and required job-specific training in the specified time frame.
• Maintains confidentiality of all department, patient, and coding matters.
• Stays current with medical terminology and human anatomy.
• Meets industry standard measures of productivity and accuracy.

Qualifications

• High School Diploma or GED - Required
• Associates Degree or Diploma School Program - Preferred
• CPC/CSS/CCA/RHIT/RHIA/CPMA - Required
• 2 year minimum - Required
• ICD-10 proficiency - Required

Requirements

Healthcare is a rapidly changing environment and technology is integrated into almost all aspects of patient care. Computers and other electronic devices are utilized across the organization and throughout each department. Colleagues must have an understanding of computers, and competence in using computers and basic software programs.