Post Acute Care Coder
Found in: beBee S US - 2 weeks ago
Job Summary:
Under direct supervision, the Post-Acute Care Coder is responsible for the accurate coding and abstracting of diagnoses, conditions, and procedures from medical record documentation for Post-Acute Care cases or services. Monitor clinical documentation and ensure accurate coding from appropriate documentation, assign the correct codes and modifiers with ICD-CM, and if applicable, CPT, and HCPCS Level II codes.
All work must be performed in accordance with the rules, regulations and/or coding conventions of ICD-CM Official Guidelines for Coding and Reporting, Coding Clinic published by the American Hospital Association, the ICD-CM, CPT, and HCPCS, Outcome Assessment Information Set (OASIS), National Correct Coding Initiative (NCCl) Edits, Office of Statewide Health Planning and Development (OSHPD), and Kaiser Permanentes organizational and institutional coding guidelines.
Essential Responsibilities:
- Review Medical Records to identify diagnoses/procedures.
- Independently organizes and prioritizes work assignments to ensure that records are coded in a timely and compliant manner and in conformance with regulatory requirements.
- Codes all appropriate diagnosis and procedures from the medical record using ICD-CM, and if applicable, CPT, and HCPCS coding classification systems.
- Responsible for the sequencing of diagnoses and procedure codes in accordance with guidelines outlined in lCD-CM, CPT, Uniform Hospital Discharge Data Set, Outcome Assessment Information Set (OASIS), Medicare regulations, and other appropriate classification systems.
- Validates abstracted data that impacts coding from the medical records to meet requirements for data submission and reporting.
- Monitor regulations and work within the guidelines to ensure that all data abstracted is consistent with guidelines outlined by TJC, OSHPD, CMS, and regional and local KP policies.
- Ensures the accuracy and integrity of data abstracted and coded based on medical record documentation prior to data submission or coding completion.
- Interacts with physicians to clarify and accurately document patient diagnostic and procedural information when appropriate, acts as a qualified coding resource for clinicians and other coding staff.
- Confidentiality/Security of Systems - Maintains and complies with policies and procedures for confidentiality of all patient records.
- Demonstrates knowledge of privacy and security of systems and associated policies and procedures for maintaining the security of the data contained within the systems.
- Other duties as assigned within the coding job function.
Basic Qualifications: Experience
- Minimum of (2) two years of continuous hospital coding experience or Post-Acute care coding experience within the last five years.
- Demonstrated completion of classes in medical terminology, anatomy, physiology, current ICD- CM and CPT coding conventions and disease process.
- High School Diploma or GED.
- Professional Coder Certificate OR Outpatient Coder Certificate OR Registered Health Information Technician Certificate OR Coding Associate Certificate OR Registered Health Information Administrator Certificate OR Coding Specialist Certificate - Physician Based OR Certified Coding Specialist
- Achieve a minimum score of 75% on the Kaiser Post-Acute Care Coder test.
- Basic knowledge of and use of computer keyboard and mouse.
- Must be able to meet productivity and quality standards established for the position (Yet to be bargained).
- Demonstrated ability to understand the clinical content of a health record and translate into the appropriate code.
- Demonstrated knowledge of anatomy, physiology, medical terminology, and disease process to interpret general medical classifications for Post-Acute Care services
- Demonstrated ability to work in an electronic medical records environment.
- Demonstrated knowledge pertaining to all guidelines that concern the coding and sequencing of diagnoses and procedures outlined in but not limited to current ICD-CM, CPT, Medicare guidelines and other sources.
- Basic knowledge of reimbursement methodologies and conventions and knowledge of rules and guidelines for the appropriate and current coding classifications.
- Must maintain coding credential and complete the required Continuing Education (CE) units.
- Must abide by the AHIMA and/or AAPC code of ethics.
- Must be willing to work in a Labor Management Partnership environment.
- The Work at Home Agreement (WAH) applies to this job position.
- BCHH-C or HCS-D or HCS-O or HCS-H or COS-C
- BCHH-C - Board Certified Home Health - Coding
- HCS-D - Home Care Coding Specialist - Diagnosis
- HCS-O - Home Care Clinical Specialist - OASIS
- HCS-H - Home Care Coding Specialist - Hospice
- COS-C - Certificate for OASIS Specialist - Clinical
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