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Out-Patient Surgery Coder (Remote Half Time)--Coding Dept.-Ft

Expired Job

Memorialcare Health System Fountain Valley , CA 92708

Posted 4 months ago

Job Summary:

  • Reviews medical records of all outpatient surgery/Wound Care (including other non-ancillary outpatient accounts) payer types to determine the principal diagnosis and procedure.

  • Utilizes query forms to consult with physician when documentation clarification is necessary

  • Following all regulatory guidelines, utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-9/10 PCS diagnoses and ICD-9/10 CPT procedures

  • Using the International Classification of Diseases (ICD9/10) and the Current Procedural Terminology (CPT) coding classification systems, assigns codes to all diagnoses and procedures following applicable coding principals and department guidelines; enters into the computer coding system

  • Abstracts and codes all required clinical and demographic data for reporting to CMS (Centers for Medicare and Medicaid Services), OSHPD (Office of Statewide Health Planning and Development), Quality Management, and Medical Staff; enters information into the computer abstracting system

  • Maintains current knowledge of the most recent ICD-9-CM/ICD-10 CM/PCS Official Guidelines for Coding and Reporting, the annual changes to the ICD9/10 diagnosis and procedure codes, the annual changes to the inpatient perspective payment system, CPT procedure codes, as well as the quarterly changes to the APC reimbursement system, and the annual changes to the reporting and reimbursement system

  • Demonstrates the ability to accurately and timely code all medical records, including Medicare, to expedite hospital reimbursement, clinical pertinence and indices

Experience & Qualifications:

  • 3 years ICD-10 coding and APC reimbursement experience in an acute care hospital setting

  • Expert knowledge 3M APC software.

  • Experience with LCD's & NCD's

  • Experience with Wound Care Coding

  • Expert knowledge of ICD-10 CM & CPT coding and coding guidelines.

  • At least one: CCS, RHIT or RHIA required

  • MUST BE ON-SITE AT SADDLEBACK MEMORIAL MEDICAL CENTER IN LAGUNA HILLS FOR FIRST 90 DAYS FOR TRAINING. THIS POSITION WILL ALSO BE WORKING ON-SITE HALF TIME FOR WOUND ACCOUNTS AND MEETINGS WITH PHYSICIANS.

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VIEW JOBS 12/1/2018 12:00:00 AM 2019-03-01T00:00 Job Summary: For the purposes of complete accurate code assignment, reimbursement, reporting and research, follows established MHS coding guidelines, Federal & State coding rules and regulations, and all Federal & State reporting requirements. Codes all payer types of outpatient surgery medical records (including other outpatient type accounts) using appropriate classification systems. Abstracts designated demographic and clinical data for profiling and benchmarking. Ensures correct code assignment, modifier use and sequencing to provide for maximum achievable accuracy & completeness of clinical documentation and allowable hospital reimbursement under the Federal Government's Perspective Payment System for ambulatory surgery, as well as ensuring appropriate scoring for benchmarking and quality reporting to CMS (Centers for Medicare and Medicaid Services), TJC (The Joint Commission), OSHPD (Office of Statewide Health Planning and Development), and other benchmarking agencies. Duties & Responsibilities: * Reviews medical records of all outpatient surgery (including other non-ancillary outpatient accounts) payer types to determine the principal diagnosis and procedure. * Utilizes query forms to consult with physician when documentation clarification is necessary * Following all regulatory guidelines, utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-9/10 PCS diagnoses and ICD-9/10 CPT procedures * Using the International Classification of Diseases (ICD9/10) and the Current Procedural Terminology (CPT) coding classification systems, assigns codes to all diagnoses and procedures following applicable coding principals and department guidelines; enters into the computer coding system * Abstracts and codes all required clinical and demographic data for reporting to CMS (Centers for Medicare and Medicaid Services), OSHPD (Office of Statewide Health Planning and Development), Quality Management, and Medical Staff; enters information into the computer abstracting system * Maintains current knowledge of the most recent ICD-9-CM/ICD-10 CM/PCS Official Guidelines for Coding and Reporting, the annual changes to the ICD9/10 diagnosis and procedure codes, the annual changes to the inpatient perspective payment system, CPT procedure codes, as well as the quarterly changes to the APC reimbursement system, and the annual changes to the reporting and reimbursement system * Demonstrates the ability to accurately and timely code all medical records, including Medicare, to expedite hospital reimbursement, clinical pertinence and indices * Demonstrates the ability to take job ownership by offering suggestions and showing a commitment to job completion * Communicates effectively with supervisor, peers and others requiring interactions * Achieves optimal APC reimbursement * Meets facility standards for correct diagnoses and procedure code assignment (ie. accuracy goals) * Meets facility standards for QM data/physician assignment/OSHPD required data * Meets WAR report productivity goals 97% of the time * MUST WORK ON-SITE AT SADDLEBACK MEMORIAL MEDICAL CENTER IN LAGUNA HILLS FIRST 90 DAYS OF EMPLOYMENT. AFTER THAT WILL WORK REMOTELY Experience & Qualifications: * 3 years ICD-9 coding and APC reimbursement experience in an acute care hospital * Expert knowledge of MS-DRG methodology * Experience with 3M APR-DRG software * Expert knowledge of Severity of Illness and Risk of Mortality methodology * Expert knowledge of ICD-10 CM & PCS coding Education: * High school diploma or GED equivalent required * At least one CCS, RHIT or RHIA required Memorialcare Health System Fountain Valley CA

Out-Patient Surgery Coder (Remote Half Time)--Coding Dept.-Ft

Expired Job

Memorialcare Health System