Saratoga Hospital Saratoga Springs , NY 12866
Posted 1 week ago
Summary of Position:#Optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases. Code and abstract diagnostic and procedural information from physician documentation in the medical record.
Summary of Position: Optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases. Code and abstract diagnostic and procedural information from physician documentation in the medical record.
Primary Job Responsibilities:
Audits utilizing the 3M Audit Expert program to optimally assign ICD-10 diagnostic and procedural codes based on information documented in the medical record. Using a computerized encoding system, facilitates and investigates coded data for inpatient and outpatient cases. Monitors the sequencing of diagnoses and procedures by following the ICD-10 Uniform Hospital Discharge Data Set (UHDDS) for Medicare, Medicaid and other fiscal intermediary requirements.
Conducts routine audits of coding, abstracting, and DRG assignment (if applicable) by coder, for Quality CMS Measure and as established criteria. Provides detailed and thorough feedback to coding staff on quality scores. Assists in growth of apprentice coders.
Performs detailed reviews, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI.
Reviews medical record documentation to assign ICD-10-CM, ICD-10-PCS and CPT4 codes, abstract data elements for billing and reporting and assign DRG, APC, and APG as appropriate.
Demonstrates knowledge of the hospital inpatient and outpatient and various applications and registration systems. Advises the coding staff of the appropriate registration patient types.
Monitors inpatient and outpatient records and investigates unbilled cases on worklists.
Communicates with management when trends or concerns arise regarding poor quality. Working closely with Medical Coding Trainer to assist in creating education topics.
Maintains patient confidential information. Maintains a secure remote work environment that is away from household traffic and protects patient confidentiality.
Adheres to HIPAA policies
Minimum Qualifications: Seven years' experience in coding ICD-10-CM/PCS and CPT coding or five years' experience with an HIM-related Associates degree or higher.
One year of experience in a leadership, supervisory, or auditing position providing quality feedback to staff. Experience with 3M 360 and EPIC is preferred. Must have experience with using an encoder.
Masterly level experience with reading a medical record to assign ICD-10-CM, ICD-10-PCS, and CPT4 codes, abstract data elements for billing and reporting, and assign DRG, APC, and APG as appropriate. High school diploma or equivalent required. Associates degree or higher within an HIM related program is preferred. Will consider applicants who are currently enrolled in good standing for an HIM college degree.
Certifications / Licensure: Certified Coding Specialist (CCS) required.
Registered Health Information Administrator (RHIA) and/or Registered Health Information Technician (RHIT) preferred. Maintains continuing education credit per AHIMA, AMA, and/or AAP.
Salary Range: $21.42 - $35.31
Pay Grade: H10
Compensation may vary based upon, but not limited to: overall experience and qualifications, shift, and location.
Saratoga Hospital