[Hiring] TCHP Coder @The Christ Hospital Health Network

Role Description

Interpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures.

• Responsible for translating healthcare providers’ diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines.
• Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance.
• Utilize technical coding principles and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures including understanding all elements in E/M coding.
• Regularly communicates with the healthcare provider to ensure documentation and coding accurately reflect care rendered utilizing supervisor and lead when needed.
• Supports healthcare provider education in areas of CMS regulations, coding, billing, documentation and administrative guidelines.
• Code at a productivity and quality rate consistent with organizational standards.
• Identify and research encounters with potential TCHHN inpatient related bills to ensure compatibility and compliance. Discuss discrepancies with facility coder to determine appropriate coding – using opportunities to teach and/or learn.
• Manages assigned provider workload in coding workflow within Epic.
• Communicates trends in coding, documentation and denials to supervisor on assigned providers and or specialty.
• Monitor documentation and coding practices to identify and follow up on potential coding related compliance issues and/or missed revenue potential.
• Maintain current knowledge base in all aspects of CPT, HCPCS, and ICD -10-CM coding.
• Keep abreast of all current billing and coding rules and regulations affecting government and non-government payers, and disseminates information to appropriate individuals as needed.
• Reviews and researches coding/billing issues, including but not limited to, rejection reports and claim denials.
• Perform regular analysis of the impact of coding and clinical documentation on reimbursement and identifies trends and opportunities for improvements.
• Adhere to compliance regulations, the Christ Hospital Code of Conduct, and the Christ Hospital Core Values and AHIMA code of Ethics while performing all duties detailed.

Qualifications

• Requires a working knowledge of Medicare regulations on charging and billing practices (UB92 and 1500/HCFA).
• Knowledge of CPT and HCPCS coding, and the ability to read/analyze itemized billing statements, medical records, & lab reports.
• Critical thinking skills needed to independently conduct Opportunity Assessments in new areas of charging.
• Must be detail-oriented, and have the ability to work in a team environment and work toward team goals.
• Ability to summarize findings and present for appropriate intervention and education.
• Proficiency in Microsoft Office applications required.
• Experience with LastWord and Groupwise helpful.
• Ability to learn and work with “Charge Capture” software (as available in market).

Requirements

• Skills assessment required to determine competency level of coding skills.
• Certified Professional Coder (CPC) or Certified Coder Specialist-Physician (CCS-P) required.
• 1 year of coding experience required, 3 years preferred.
• Demonstrated knowledge of HCPCS, ICD-10 and CPT coding guidelines, medical terminology, anatomy and physiology.
• Ability to accurately code diagnosis, diagnostic and surgical procedures with a depth of knowledge in Evaluation and Management (E/M) coding within a specialty or service line.
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation.
• Demonstrated effective verbal and written communication skills.
• Research skills including knowledge of automated analysis tools and online research tools to resolve complex coding and healthcare issues.
• Demonstrated ability to effectively work within a team environment, using excellent written, verbal, and presentation skills to share audit findings, risk areas, and compliance issues with coders, office managers, physicians, etc.
• Maintains confidentiality and protects sensitive data at all times.

Licenses & Certifications

• Certified Professional Coder (CPC) or Certified Coder Specialist-Physician (CCS-P) required.