Key Responsibilities:
· Complies with all policies and procedures that pertain to HIPAA including minimum necessary requirements for this position. Must maintain 100% patient confidentiality for e-PHI during the course of work functions
· Responds to inquiries from Business Office on patient claims resolution
· Assists coding team with inquiries from departments to achieve timely resolution
· Assists coding team to ensure coding accuracy, completeness, and adherence to established guidelines and standards
· Participates in meetings with Revenue Cycle Committee and coding team
· Abides by the Standards of Ethical Coding set forth by AHIMA and monitors coding staff for violations and reports as areas of concern are identified
· Assists HIM Director in maintaining compliance with applicable regulations (e.g., ICD-10, CPT, or internal standards)
· Train new staff and existing staff on coding standards, tools, and updates
· Maintains knowledge of current professional coding certification requirements and promotes recruitment and retention of certified staff in coding positions
· Develops reports and collects and prepares data for studies involving cases for clinical evaluation purposes, fiscal impact, and profitability
· Assists HIM Director with developing and implementing coding policies, procedures, and best practices
· Assist HIM Director with tracking key performance metrics such as accuracy rates, productivity, and turnaround times
· Keeps abreast of recent technology in coding software and other forms of automation and stays informed about transaction code sets, HIPAA requirements and other future issues impacting the coding function
· Demonstrates competency in the use of computer applications and grouper software, medical edits, and all coding software and hardware
· The supervisor should demonstrate initiative and discipline in time management and assignment completion
· The supervisor must be able to work in a virtual setting under minimal supervision
Qualifications:
Required Education:
Associate or bachelor’s Degree and accredited by AHIMA
Required Licenses and/or Certifications:
Certified Coding Specialist (CCS) and Certified Professional Coder (CPC) Certifications
Required Work Experience:
Five (5) years in relevant working field, with one (1) year of supervisory experience
Required Knowledge, Skills, and Abilities:
· Advanced knowledge of ICD-10-CM and CPT coding principles and rules
· Strong leadership and communication skills
· Problem solving
· Good knowledge of medical records systems
· Excellent computer applications knowledge including Microsoft Word and Excel
· Must be fluent in general information technologies
· Significant level of autonomy, must be self-directed
· Intermediate to advanced knowledge of disease pathophysiology and drug utilization
· Intermediate to advanced knowledge of MS-DRG and APR-DRG classification and reimbursement structures
· Advanced knowledge of APC, OCE, NCCI classification and reimbursement structures
· Excellent organizational skills for initiation and maintenance of efficient workflow
· Regular and reliable attendance and time reporting per Gritman Medical Center Telecommuting program requirements
· Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment
· Good visual acuity
· Ability to operate computer keyboard, mouse, and other peripherals as appropriate to accomplish coding
Preferred Qualifications:
Prefer five (5) years' experience in a supervisory role in healthcare with extensive knowledge of ICD-10-CM, CPT, HCPCS, and documentation guidelines;
EPIC experience, including HB and PB billing.