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Clinical Coding Specialist
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We are seeking a highly skilled Health Information Management Specialist to join our team at Sierra View Local Health Care District. As a key member of our HIM department, you will be responsible for reviewing, abstracting, coding, and conducting risk surveillance on medical records for statistical, administrative, billing, and risk surveillance purposes.
Key Responsibilities- Analyze and interpret patient medical records to identify and determine the amount and nature of billable services, and assign and sequence appropriate diagnostic/procedure billing codes in compliance with government and third-party payer requirements.
- Perform data entry into online medical record abstracts and verify the accuracy of the data imported back from the 3M encoder system.
- Determine the appropriate onset of diagnosis Present on Admission (POA) indicator for each diagnosis to identify adverse outcomes, collect additional data on risk events as required, and identify and report sentinel events for Risk Surveillance as directed.
- Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other non-compliant practices, and prepare periodic reports for clinical staff identifying unbilled charges due to inadequate documentation.
- Stay current with all coding-related regulations and reimbursement activities to optimize our revenue cycle management from a coding perspective.
- Assure timeliness of the coding process by maintaining a running list of accounts not coded and rechecking for codability.
- Meet quality standards of having 95.5% of principal diagnoses and procedures appropriately and correctly coded.
- Maintain a 95.5% monthly productivity rate.
- High school graduate or equivalent.
- Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) and/or CCS-P) or Certified Professional Coder (CPC), or equivalent approved certification, with a minimum of 2 years coding experience in an acute care facility using ICD-9-CM and CPT/DRG assignment.
- Knowledge of ICD-10-CM coding principles for both acute care and skilled nursing facilities.
- Knowledge of the prospective payment system and impact of codes upon reimbursement required.
- Knowledge and experience in medical terminology, anatomy, and physiology.
This is a full-time position that requires normal/scheduled working hours, including holidays, call-backs, weeknights, weekends, and on-call. The employee shall work well under pressure, meet multiple and sometimes competing deadlines, and demonstrate cooperative behavior with colleagues and supervisors.
