[Hiring] Senior Coder @Dignity Health

Role Description

As a Medical Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time.

Core Coding & Data Integrity:

• Applies expert-level knowledge to accurately assign and sequence ICD-10-CM, CPT, and HCPCS codes to outpatient medical records and encounters.
• Ensures coding decisions are fully substantiated by medical record documentation and adhere to official coding guidelines, payer requirements, and the Standards of Coding Ethics.
• Analyzes APCs (Ambulatory Payment Classifications) and modifier assignments to ensure thorough and compliant coding and charging, utilizing designated coding applications and systems to accurately code and abstract all assigned encounters.

Documentation Review & Integrity:

• Identifies conflicting, ambiguous, or incomplete documentation within medical records and initiates appropriate physician queries to obtain necessary clarifications.
• Works collaboratively with providers and other departments to ensure accurate and complete clinical documentation and resolve charge discrepancies.

Productivity, Quality & Confidentiality:

• Reviews assigned work queues, prioritizing and coding all assigned encounters within established department productivity and turnaround time frames, consistently meeting quality and accuracy standards set by Coding Leadership.
• Complies with all applicable laws, rules, regulations, and organizational policies, including reporting suspected violations.
• Maintains strict patient, medical record, department, and employee confidentiality at all times.
• Actively participates in professional development, fulfilling continuing education requirements and maintaining professional credentials.
• Contributes to a positive team environment and fosters effective communication with colleagues and leadership.

Professional Development & Departmental Contribution:

• May assist with new hire onboarding, provide mentorship, contribute to audit processes, and various reports. Performs other duties as assigned.
• Offers insights and suggestions for enhancing coding workflows, efficiency, and documentation improvement initiatives based on daily coding experience.
• Provides feedback on proposed coding policies and procedures, utilizing expert knowledge to identify potential impacts on coding accuracy or workflow.
• Offers guidance and shares expertise with less experienced coders on challenging cases or coding complexities, under the direction of leadership and without formal supervisory responsibility.
• Actively participates in departmental meetings, contributes to a positive team environment, and fosters effective communication with colleagues and leadership.

Qualifications

• High School Graduate
• Completion of a CAHIIM Approved AHIMA/AAPC Accredited Coding Education and 3 years Coding Experience (Inpatient, Outpatient, Professional Fee, &/or Outpatient Physician Clinics) using ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS coding
• Electronic Medical Record (EMR) and encoder experience
• Certified Professional Coder
• Certified Coding Specialist
• Certified Coding Specialist - Physician Based
• Certified Professional Coder Hospital
• Registered Health Information Administrator
• Registered Health Information Technician