Employment Type:
Full time
Shift:
Day Shift
Description:
CODING SPECIALIST III - Hybrid - Albany - FT
If you are looking for a remote Coding Specialist position, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places.
Office Location: 319 South Manning Blvd
Ambulatory Surgery Coding Experience Highly Preferred
Position Highlights:
Recognized leader: Magnet Hospital in the Capital Region
Quality of Life: Where career opportunities and quality of life converge
Advancement: Strong orientation program, generous tuition allowance and career development
Work/Life: M-F Office Hours
Position Purpose:
Provides high level technical competency and subject matter expertise analyzing physician/provider documentation contained in assigned Complex Outpatient (CO) and Inpatient health records (electronic, paper and hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Provides appropriate Medical Severity Diagnostic Related Groups (MS-DRG), Present on Admission (POA), Severity of Illness (SOI) & Risk of Mortality (ROM) assignments for Inpatient records and accurate APC assignments and all required modifiers for Complex Outpatient records.
Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis and procedure codes, Current Procedural Terminology (CPT)-4/ Healthcare Common Procedure Coding System (HCPCS) procedure codes, MS-DRG, POA, SOI & ROM assignments and assignment of APC's and all required modifiers.
Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA) Coding Clinic for ICD-9-CM, American Medical Association (AMA) for CPT-4 codes and CPT Assistant, American Health Information Management Association (AHIMA) Standards of Ethical Coding, Unified Revenue Organization/Ministry Organization (URO/MO) coding policies and Trinity Health Coding Manual (TBA).
Essential Functions:
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs.
Codes Complex Outpatient or Inpatient utilizing encoder software and online tools and references, in the assignment of ICD-9-CM, ICD-9-PCS, CPT-4, HCPCS codes, MS-DRG, POA, SOI & ROM assignments, APC assignment and all required modifiers.
Validates charges by comparing charges with health record documentation as necessary.
Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record.
Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialists (CDIS) regarding documentation issues or needs related to Inpatient coding.
Collaborates with Regional Shared Services (HIM and Patient Financial Services) in resolving billing and utilization issues affecting reimbursement.
Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems.
Tracks issues (i.e., missing documentation, charges or Inpatient queries that require follow-up to facilitate coding in a timely fashion.
Consistently meets or exceeds coding quality and productivity standards established by URO/MO.
Adheres to Trinity Health and Ministry Organization confidentiality requirements as they relate to the release of any individual or aggregate patient information.
Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
Performs other duties as assigned by leadership.
Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
Minimum Qualifications:
Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate's degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required. Bachelor's degree in Health Information Management (HIM) or related healthcare field is preferred.
Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technologist (RHIT), or Registered Health Information Administrator (RHIA) is required.
Two (2) years of current Complex Outpatient or Inpatient coding experience is required. Three (3) to five (5) years of current Complex Outpatient or Inpatient coding experience preferred. Current experience doing remote coding is a plus.
Extensive comprehensive working knowledge of medical terminology, Anatomy and Physiology, diagnostic and procedural coding and MS-DRG or APC grouping. Current experience doing remote coding is a plus.
Current experience utilizing encoding/grouping software is preferred. Ability to utilize both manual and automated versions of the ICD-9-CM and CPT4 coding classification systems is preferred.
Ability to use a standard desktop and windows based computer system, including a basic understanding of e-mail, internet, and computer navigation. Ability to use other software as required to perform the essential functions on the job. Familiarity with distance learning or using web-based training tools desirable.
Strong written and oral communication skills, that may be used either on-site or in virtual working environments.
Ability to communicate effectively with individuals and groups representing diverse perspectives.
Ability to work with minimal supervision and exercise independent judgment. Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload.
Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills. Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions. Ability to change and be flexible with work priorities. Strong problem solving- abilities.
Must be comfortable functioning in a virtual, collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
Pay Range: $22.25-$34.79
Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
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