Senior Medical Coding Specialist
Category: Clerical
Facility: Genesis Medical Group
Department: GMG - Physician Coding
Schedule: Full Time
Shift: Day Shift
Hours: 80 bi-weekly / 8:00am-5:00pm (Intradepartmental Only)
Contact Information: Contact: Human Resources
Job Details:

JOB SUMMARY

Works one-on-one with physicians and advanced practitioners  to ensure optimal, correct, and timely coding.  Organizes coding timelines and goals for acute-care coding specialties and tracks compliance with these measures.  Collects patient information from Genesis Medical Group providers to code and bill charges.  Codes medical claims along with charge entry and daily reconciliation.

 

ESSENTIAL DUTIES

1.     Audits coding selections and educates  physicians and advance practitioners to ensure compliant and timely coding within the requirements of Genesis Medical Group by working one-on-one with each provider.

2.     Tracks and maintains timeliness and correctness of provider coding under the supervision of the coding manager.

3.     Optimizes reimbursement, which Genesis HealthCare System is legally entitled to, by applying effective coding strategies.

4.     Reviews and applies coding and reimbursement resources in a timely manner to ensure an up to date knowledge base.

5.     Assigns and reports codes that are clearly and consistently supported by provider documentation in the health record.

6.     Discerns clinical notes, uses skills and knowledge of currently mandated coding and classification systems and office resources to select the appropriate diagnostic and procedural codes.

7.     Assists and educates physicians and other clinicians by advocating proper documentation practices, further specificity and re-sequencing or inclusion of diagnoses or procedures to more accurately reflect the acuity, severity and occurrence of events.

8.     Consults providers for clarification/additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.

9.     Ensures accurate, complete and consistent coding practices for the production of quality healthcare data.

10.   Adheres to the ICD coding conventions, official coding guidelines, CPT rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets.

11.   Collaborates with other departments regarding proper documentation, coding conventions, and official coding guidelines.

12.   Consistently applies coding and reimbursement rules and identifies and reports inappropriate coding practices.

13.   Routinely abstracts clinical information from the medical record according to department procedure.

14.   Assists in training of other staff in computer applications and department procedures.

15.   Establishes report parameters to produce meaningful data.

16.   Verifies patient identity to ensure correct filing of patient information.

 

QUALIFICATIONS

1.     Associates degree, or a minimum of three (3) years experience in acute care coding.

2.     Must possess one of the following current certifications: CPC, CCS, RHIA or RHIT.

3.     Prior experience auditing E&M and surgical documentation.

4.     Knowledge of medical terminology, anatomy, and physiology.

5.     Demonstrates understanding of various coding and reimbursement systems including ICD and CPT.

6.     Ability to analyze and interpret clinical data.

7.     Demonstrates critical thinking skills to make appropriate interventions.

8.     Excellent verbal and written communication skills.

9.     Demonstrates data entry skills, with knowledge of various software applications, including spreadsheet and database.

 

WORKING CONDITIONS/PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential function of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1.     Ability to sit up to 8 hours.

2.     Ability to maintain concentration during times of frequent interruptions.

3.     Ability to read handwritten and printed material, and computer monitor.

4.     Ability to tolerate stress related to the mental and physical demands of the position.

 

This description reflects in general terms the type and level of work performed.  It is not intended to be all-inclusive, nor portray the specific duties of any one incumbent.




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