Details
Posted: 05-May-22
Location: Cincinnati, Ohio
Salary: Open
DescriptionAt Cincinnati Children's, we believe in nurturing employees' lives as well as their careers. Our benefits equal or surpass other hospitals in the region, and we're proud to offer one of the best working environments in our field to include opportunities to advance your career within our organization. Our benefits help you manage your health, protect you if you are unable to work, help you further your education, and prepare for retirement.We are looking for an experienced inpatient hospital DRG coder. Knowledge in PCS, DRG assignment, ICD-10 CM, etc. Systems- EPIC and 3M/360. Knowledgeable in PCS, DRG assignment, ICD-10 CM, etc. Systems- EPIC and 3M/360. Experience with PCS and CPT coding experience for surgery coding and HB and PB, infusion and injection coding for ED coding. Procedures and modifiers. Should have 5 years of experience. Children's experience is a bonus
SUBFUNCTION DEFINITION: Prepares and forwards patient claims to appropriate third-party payers. Analyzes and reviews claims to ensure that payer-specific billing requirements are met. Follows up on billing, determines and applies appropriate adjustments, answers inquiries and updates accounts as necessary.
PURPOSE OF POSITION: Provides support to the hospital ensuring accurate and timely diagnosis and procedure coding and abstracting of medical records within a paperless environment utilizing a hybrid electronic medical record and electronic encoding product.
REPRESENTATIVE RESPONSIBILITIESCoding and AbstractingReviews and screens the medical record to abstract designated statistical and clinical data and enters reliable information into 3M's Data Management System, Epic, and/or Fastrack, as appropriate. Assigns ICD-9-CM, ICD-10-CM/PCS, and CPT-4 codes and modifiers to accounts in an accurate and ethical manner utilizing 3M encoding software and coding manuals. Reviews encounters holding for additional documentation or other clarification on a regular basis in order to ensure completion of coding for timely billing. Meets or exceeds all established productivity standards. Submits completed coding activity logs in a timely manner. Effectively manages work responsibilities to meet deadlines, and departmental and organizational bill hold and AR goals.
Coding QualityPerforms coding of Inpatient, Outpatient Surgery, Observation, Infusion, and/or Ancillary accounts with accurate application of ICD-9-CM, ICD-10-CM, ICD-10-PCS, and/or CPT-4 coding guidelines. Uses available references to ensure compliant code assignment. Meets or exceeds established quality standards for coding and abstracting responsibilities. Demonstrates accuracy in reporting inpatient grouping methodologies and/or outpatient payment methodologies and CCI edits, as appropriate.
Professional DevelopmentMaintains currency of CMS, State of Ohio, official coding and other guidelines, rules and regulations, and applies principals as appropriate. Identifies and assumes responsibility for learning needs. Integrate new knowledge into practice. Successfully completes a minimum of 20 hours of continuing education every two years. Maintains currency in the field through continuing education, literature and seminars and maintains current credentials/licensure.
Customer ServiceProvides meaningful and timely feedback in a professional manner to intradepartmental, organizational, and external customers. Participates in customer service initiatives.
Performance ImprovementIdentifies opportunities for improvement in Coding processes. Communicates ideas to Coding management. Assists in testing new or upgraded systems applications and processes. Actively participates in departmental and/or organizational Performance Improvement projects as assigned.
Data ManagementPerforms medical record review audits as assigned and accurately compiles and communicates related data. Identifies and communicates to HIM coding management and/or the Data Quality team gaps identified in clinical terminologies and medical vocabularies utilized in coding and abstracting processes, as compared to that which is present in the electronic health record documentation. Ensures coded data integrity by cross referencing information contained in all electronic patient information systems.
QualificationsEDUCATION/EXPERIENCERequired:???Associate's degree in a health related field OR Equivalent combination of education and experience
???Certification/credentialed as Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT), or Registered Health Info Admin (RHIA) OR Certified Professional Coder (CPC), Certified Coding Specialist-Physician (CCS-P)
???Two years of coding experience in a complex medical center
???Successful completion of hospital's administrated Coding Competency test
Preferred:???Experience in all aspects of pediatric ICD-9-CM/PCS and CPT-4 coding.
???Computerized Encoder Experience
Unique Skills:???Prioritization
Using time efficiently and productively; prioritizing multiple tasks properly to meet deadlines; recognizing time constraints and adjusting work schedule to address them.
???Diversity Appreciation
Understanding and showing respect and appreciation for the uniqueness of all individuals; leveraging differences in others' perspectives and ideas; appreciating cultural differences and adjusting one's approach to successfully integrate with others who are different from oneself
???Computer Hardware - Basic
Basic understanding of hardware usage and troubleshooting
???Organization
Strong organizational and project management skills to handle projects independently.
???Problem Solving
Ability to independently work through details of a problem to reach a positive solution
???Communication
Excellent verbal, written and/or interpersonal communication skills
???Coding
Possess knowledge of ICD-9-CM, CPT-4, ICD-10-CM, and ICD-10-PCS coding systems and guidelines. Knowledgeable in CMS, Ohio Medicaid, and other regulatory agency rules and regulations related to coding and reimbursement.
???Analysis
Basic review of data, work queues, and reports.
???Computer Skills - Basic.
Working knowledge of basic computer applications such as Microsoft Office, email and internet.
