[Hiring] Senior Coder - PB Professional Coding - Cardiology Specialty @LCMC Health

Role Description

The Coding Senior will be responsible for applying the appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determining the MS-DRG and APR-DRG assignment of inpatient records across multiple specialties or applying the appropriate ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties.

• Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedure codes, MS-DRGs and APCs assignment and all required modifiers.
• Validates charges by comparing charges with health record documentation as necessary.
• Communicates effectively with clinical staff, physicians, and office staff regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
• Identifies concerns and notifies appropriate leadership for resolution.
• Tracks issues (i.e. missing documentation, charges, and physician queries) that require follow-up to facilitate coding in a timely fashion.
• Consistently meets or exceeds coding quality and productivity standards established by the coding department.
• Adheres to LCMC confidentiality requirements as they relate to the release of any individual or aggregate patient information.
• Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
• Performs other duties as assigned by leadership.
• Maintains working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Code of Ethics, as well as other policies and procedures.

Qualifications

• Completion of an AHIMA approved coding program or an AAPC approved coding program or Associate degree in health information management or related field or an equivalent combination of years of education and experience required.
• Minimum two (2) years of current complex outpatient and inpatient coding required.
• Certified Coding Associate (CCA) from AHIMA or Certified Inpatient Coder (CIC) and Certified Outpatient Coder (COC) combination from AAPC required.
• Internal staff who are not certified must obtain medical coding certification within twelve months through an approved LCMC coding program.
• Comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding, and MS-DRG or APC grouping.
• Knowledge of third-party reimbursement regulations and billing practices.
• Experience utilizing encoding/grouping software.
• Ability to use standard desktop and windows-based computer systems, including basic understanding of email, internet, and computer navigation.
• High ethical standards.
• Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG, and APC coding principles and guidelines.
• Experience in ICD-10-CM/PCS coding and reimbursement training.
• Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory, and provider-based clinic encounters.
• Knowledge of hospital and professional coding including provider-based billing.
• Knowledge of documentation regulations of Joint Commission and CMS.
• Experience with concurrent coding reviews.
• Knowledge of privacy and security regulations, confidentiality, laws, access, and release of information practices.
• Experience in assisting and identifying learning needs as well as providing training to coding staff.
• Strong analytical abilities and problem-solving skills.
• Excellent oral, written, and interpersonal communication skills.
• Ability to organize and set priorities to ensure objectives are met in a timely manner.
• Ability to adapt to change and handle challenges proactively.
• Ability to effectively collaborate with physicians and managerial staff at all levels.

Requirements

• Variable Hours (United States of America).

Benefits

• Deliver healthcare with heart.
• Give people a reason to smile.
• Put a little love in your work.
• Be honest and real, but with compassion.
• Bring some lagniappe into everything you do.
• Forget one-size-fits-all, think one-of-a-kind care.
• See opportunities, not problems – it’s all about perspective.
• Cheerlead ideas, differences, and each other.
• Love what makes you, you - because we do.