[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.

Responsibilities

• Reviews inpatient medical records and assigns diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS.
• Adheres to AHIMA ethical coding standards, official coding guidelines, and RRH/HIM policies and procedures.
• Meets departmental productivity standards while maintaining 95% coding accuracy.
• Utilizes Care Connect, UDS, and Clintegrity systems for coding and DRG assignment.
• Formulates compliant physician coding queries when documentation is inadequate, ambiguous, or unclear.
• Accurately enters and updates coding data, including POA indicators, point of origin, and discharge disposition.
• Resolves workflow edits, billing errors, and coding-related claim issues in a timely manner.
• Supports physicians and clinical quality staff with documentation improvement, coding reimbursement, and quality review processes.

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.
• Grandfather Clause: If hired on or before September 30, 2018, 2 years of relevant work experience and one of the following coding certification credentials: 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), or a specialty coding certification and Associate’s degree in Health Information Management are required.

Education

• AS: Health Information Management (Required)

Physical Requirements

• Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67–100% of the workday) with minimal physical effort and lifting limited to under 10 lbs.
• Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability.
• Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing.
• Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents.
• Some roles may require flexible hours, TB screening, or a valid driver’s license.
• 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.

Pay Range

$22.00 - $32.00