[Hiring] Facility Coder - Certified @Confluence Health

Role Description

The Certified Facility Coder will be responsible for reviewing all medical record information to extract data and apply appropriate diagnoses and procedure codes for billing, internal and external reporting, research, and regulatory compliance.

• Accurately codes conditions and procedures as documented in the Official Guidelines for Coding and Reporting for Hospital Departments.
• Acts as a coding resource for team members as well as medical staff, ensuring coding practices fall within the established compliance guidelines for ICD-10CM/PCS, CPT & HCPCS according to American Medical Association (AMA) and CMS.
• Assigning codes utilizing an electronic encoder application in accordance with the practice policy and regulatory guidelines.

Qualifications

• High School Diploma or equivalent GED.
• Minimum 1 year coding experience or equivalent education/experience.
• Knowledge of ICD-10, CPT coding, medical terminology, anatomy, and insurance billing.
• Understanding of DRG’s for Inpatient Facility coding positions.
• Possesses basic computer (e.g., spreadsheets, word processing) skills.
• One of the following coding certifications: CPC (CPC-A), CIC, COC (COC-A) from American Academy of Professional Coders (AAPC) or CCA, CCS, CCS-P, RHIA, RHIT from American Health Information Management Association (AHIMA).

Requirements

• Facility coders are responsible for coding: Inpatient, Ambulatory, Observation, Emergency Department which includes charge capture, charging medication administration and knowledge of multiple specialties consultation/procedures.
• Ability to extract and assign ICD-10CM/PCS, CPT, Modifiers and HCPCS codes per coding guidelines and appropriate service utilizing an electronic encoder application in accordance with hospital policy and regulatory body guidelines.
• Inpatient diagnoses and procedures shall be coded in accordance with UHDDS definitions for principal and additional diagnoses and procedures as specified in the Official Guidelines for Coding and Reporting.
• Understanding/assign DRG’s, MC’s and CCs for Inpatient Facility Coding.
• Reviews accounts and charges in EPIC.
• Review and adjust coding for Part A/B rebilling.
• Ability to research Coding Clinics.
• Reviewing medications to apply appropriate infusion administration charges.
• Assists with coding audits from payor and RAC audits providing rebuttal letters if needed.
• Codes all records based on documentation, following coding guidelines, payer regulations and ethics.
• Demonstrate knowledge of CMS Hierarchical Condition Category (HCC) Risk Adjustment coding.
• Apply knowledge of coding rules, review and resolve CCI/LCD/NCD’s and modifier edits.
• Effectively uses software and/or coding books to verify coding accuracy.
• Responsible to stay current with billing guidelines and reimbursement rules and regulations.
• Work with Revenue Integrity & Compliance on audits and coding questions.
• Contribute as a team member with our Clinical Documentation Specialists.
• Provides feedback to providers using authorized methods as directed by department policy.
• Works with clinical staff to resolve coding issues and related problems.
• Participates in educational activities as requested (i.e. attending meetings with clinical staff).
• Maintain department coding production standards for the specialties you are assigned to code.
• May be requested to perform job tasks not specifically related to primary assignments for the success of the organization as requested by management.
• Performs other duties as assigned.
• Demonstrate standards of behavior and adhere to the Code of Conduct in all aspects of job performance at all times.

Benefits

• Medical, Dental & Vision Insurance
• Flexible Spending Accounts & Health Saving Accounts
• Paid Time Off
• Generous Retirement Plans
• Life Insurance
• Long-Term Disability
• Gym Membership Discount
• Tuition Reimbursement
• Employee Assistance Program
• Adoption Assistance
• Shift Differential