[Hiring] Coder III Specialist - Professional Specialty Services @Franciscan Health

Role Description

The Coder III Specialist- Professional Specialty Services- Procedural reviews electronic medical record documentation, and applies ICD and CPT codes, per Official Coding Guidelines, with a specific focus on office visit and/or minor surgical procedures. This position abstracts key data elements necessary for billing and data analysis.

• Data Analysis- Professional Coding: Reviews and analyzes the content of the medical record to determine when documentation should be utilized for appropriate assignment of ICD diagnosis codes, CPT repetitive or non-invasive procedure codes, modifiers, hierarchical condition categories, complications, and comorbidities to meet coding guidelines.
• Data Analysis- Professional Coding: Accurately reviews and codes patient records in the following clinical areas: professional office visits and/or minor surgical procedures.
• Data Interpretation- Professional Coding: Evaluates appropriateness of diagnosis and procedure codes and modifiers utilized in response to Outpatient Code Editor and National Correct Coding Initiative edits.
• Clinical Documentation Analysis: Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses. Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and takes steps to obtain the documentation.
• Abstracting Data: Identifies and enters data elements for abstracting.
• Coding Accuracy: Meets defined coding accuracy standards.
• Coding Productivity: Meets defined coding productivity standards.
• Subject Matter Expert- Coding: Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.
• Subject Matter Expert- Coding: Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing.
• Subject Matter Expert- Coding: Remains current with coding and industry changes through participation in educational opportunities.
• Subject Matter Expert- Professional Coding: Demonstrates a thorough knowledge of professional coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines.
• Process Improvement: Notifies coding leadership of trends and topics for education and feedback to physicians and departments.
• Process Improvement: Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
• Ethics: Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.

Qualifications

• High School Diploma/GED - Required
• Associate's Degree Health Information Management - Preferred
• Bachelor's Degree Health Information Management - Preferred
• 1 year Coding - Required
• CCS (Certified Coding Specialist) - American Health Information Management Association (AHIMA)
• CCS-P (Certified Coding Specialist - Physician) - American Health Information Management Association (AHIMA)
• CPC (Certified Professional Coder) - American Academy of Professional Coders (AAPC)
• RHIT (Registered Health Information Technician) - American Health Information Management Association (AHIMA)
• RHIA (Registered Health Information Administrator) - American Health Information Management Association (AHIMA)

Requirements

• Travel is required: Never or Rarely
• Job Range: Coder III Spcl Profess Specialty Srvc Procedural $19.46-$28.96

Benefits

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.