[Hiring] Coder II @Augusta Health Careers

Role Description

The Coder II, under the direction of the Health Information Management Director and the Coding Manager, follows all regulatory guidelines in the reporting and sequencing of ICD-10-CM, HCPCS, and HCPCS Level II CPT codes. Generates coding queries to physicians to clarify patient condition(s) when conflicting or ambiguous information is reflected in the patient record. Understands their role in quality performance measures and serves as a resource to the Business Office in the reconciliation and resolution of problematic accounts.

Essential Job Duties

• Accurately enter ABS data (e.g. Surgeon name, procedure date, discharge disposition, admit diagnosis, POA status, etc.)
• 95% + Accuracy
• Meets or exceeds bill drop dates/AR expectations
• Consistently monitors and manages AR to facilitate dropping of pending, old, or problematic accounts of assigned locations in accordance with 30-Day Bill Drop policy.
• Consistently meets established bill drop dates.
• Percentage of weeks in which bill drop dates are met: 90% of the time
• Accurately reports principal diagnosis in keeping with the most current AHA Coding Clinic and ICD-10-CM/ICD-10CM guidelines.
• 95% + Accuracy
• Manages NCCI and OPPS edits in compliance with industry regulations.
• Appends modifiers to charges when appropriate.
• Notifies Business Office and corresponding ancillary department when charges should be removed or added.
• Identifies and reports to supervisor recurring charge issues that can be addressed with ancillary department managers.
• Generates appropriate query selection based on clinical evidence established in the patient medical record.
• Formats non-standardized queries in keeping with AHA Coding Clinic, CMS, and QIO guidelines.
• Utilizes standardized query templates when available.
• Maintains established Productivity Standards:
• Same Day Surgery: 6 accounts per hour
• Observation: 5 accounts per hour
• Emergency Room: 12 accounts per hour
• Ancillary encounters: 30 accounts per hour
• Meets or exceeds the expected DRG/APC accuracy rate of 95%
• Accurately reports procedure codes
• All ICD-10-CM and CPT procedure codes are accurately coded and reported in keeping with AHA Coding Clinic, CPT Assistant, ICD-10-CM, CPT-4, and/or unique payer coding and reporting guidelines.
• Submits Productive/Non-Productive variation report with established timeframe, due on Mondays following the end of each pay period with a 3-day grace period.
• Accurately reports secondary diagnoses in keeping with the most current AHA Coding Clinic and ICD-10-CM/ICD-10-CM guidelines.
• Outpatient: 95% + Accuracy

Qualifications

• Education: High School Diploma or GED equivalent
• Licensure/Certification: CCS or CPC
• Experience: Outpatient Coder - Coding Certification
• Eligibility to work in the United States and meet Virginia state employment requirements

Preferred Qualifications

• Education: Accredited Coding Program
• Licensure/Certification: CCS, RHIT, RHIA, CCA, COC, CIC, CPC-A
• Experience: Three years coding
• Prior experience in a hospital, healthcare system, or related service-oriented environment
• Familiarity with Augusta Health’s systems, workflows, or organizational culture is a plus

Competencies, Knowledge, Skills and Abilities

• Requires good written, oral communication and interpersonal skills.
• Ability to effectively communicate with all hospital practitioners is essential.
• Demonstrates competency in the use of computer applications and grouper software, Medicare edits, and all coding and abstracting software and hardware currently in use by HIM.
• Requires comprehensive knowledge of anatomy and physiology, medical terminology and disease processes.
• Requires analytical ability to allow for interpretation of clinical data in all clinical specialties to determine appropriate code assignment.
• Requires proficiency in abstracting chart data into computer module.
• Requires ability to work independently, an eagerness to learn, attention to detail and good critical thinking skills.
• Must possess high ethical standards due to confidential nature of patient information.

Benefits

• Comprehensive insurance package including medical, dental, and vision coverage
• Retirement savings plans and financial wellness support programs
• Earned Wage Access Program, allowing eligible team members to access a portion of earned wages before payday
• Generous paid time off and flexible scheduling to promote work-life balance
• Career development programs including clinical ladders, shared governance, and advancement opportunities
• Personalized onboarding with dedicated preceptors and ongoing educational support
• Tuition reimbursement and access to onsite childcare
• Free onsite parking, 24/7-armed security for your safety, a Health Fitness Reimbursement Program, and an onsite credit union and pharmacy
• Competitive pay with shift/weekend differentials
• Employee discounts at the cafeteria, gift shop, pharmacy, and local entertainment venues (i.e., movie tickets)