[Hiring] Coder @Rochester Regional Health

Role Description

Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for billing, internal and external reporting, research, and regulatory compliance. Demonstrate knowledge of reimbursement methodologies and apply these to assigned charts to optimize reimbursement and/or resolve regulatory edits. Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors.

Qualifications

• One of the following certifications is required:
  • Certified Coding Specialist (CCS)
  • Certified Coding Specialist - Physician Based (CCS-P)
  • Certified Professional Coder (CPC)
  • Certified Professional Coder Hospital Based (CPC-H)
  • Certified Medical Coder (CMC)
  • Registered Health Information Technician (RHIT)
  • Registered Health Information Administrator (RHIA)
  • Certified Professional Coder Apprentice (CPC-A)
  • Specialty coding certification
• Candidate with Associate degree from an accredited American Health Information Management Association (AHIMA) are required to sit for the Registered Health Information Technician (RHIT) exam within 1 year of hire.
• At least 2 years of progressive coding experience in a hospital or multi-specialty physician practice setting preferred.
• For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification required within 16 months of hire.

Requirements

• Meets established departmental productivity guidelines with 95% accuracy on a consistent basis.
• Utilizes Care Connect, UDS, and Clintegrity systems proficiently to obtain ICD10 codes and DRG assignment.
• Formulates compliant Physician Coding Queries when documentation is inadequate, ambiguous, or unclear for coding purposes.
• Enters and/or updates data accurately including Present on Admission (POA) indicators, Point of Origin, Discharge Disposition, and other identified data.
• Manages problematic workflow edits and other technical issues to ensure timely resolution specific to coding A/R days.
• Corrects failed claim errors to billing edits, accounts misclassified, and/or other errors identified through various auditing processes in a timely manner.
• Attends RGHS, HIM Department, and Coding Team meetings and training sessions as required.
• Ensure timely reporting for external regulations.
• Completes other duties as assigned by HIM leadership.
• Provide assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process.

Benefits

• Pay range: $22.00 - $32.00
• The listed base pay range is a good faith representation of current potential base pay for a successful full-time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Education

• AS: Health Information Management (Required)

Physical Requirements

• S - Sedentary Work - Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
• For disease-specific care programs refer to the program-specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
• Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.