[Hiring] Trainee Clinical Coder / Clinical Coder @North Tees and Hartlepool NHS Foundation Trust

Role Description

The post-holder will be responsible for the clinical coding of inpatient and day-case episodes across all specialties provided at North Tees and Hartlepool Hospitals.

The post involves liaising with clinicians and clinical teams on a regular basis to verify data recorded in patient case-notes and on electronic systems.

This post may close early if sufficient amount of applications are reached.

• Undertake office based clinical coding training and NHS England Clinical Coding Standards Course to achieve proficiency in clinical coding.
• Abstract clinical information from the electronic system to translate this into diagnostic (ICD10) and operative (OPCS4) codes in a timely and accurate manner, applying national and international classification rules and conventions.
• Abstract clinical information from the case-note/electronic system to translate this into diagnostic (ICD10) and operative (OPCS4) codes in a timely and accurate manner, applying national and international classification rules and conventions.
• Liaise with hospital wards and other departments as necessary to view information in source documentation (case notes), required to complete coding; to collect source document sheets (e.g. discharge summaries); to take reasonable steps to chase up outstanding source data. Source documents will increasingly include electronic records.
• Contribute to improvements in accuracy and completeness of clinical coding for admitted care.
• Attend meetings to discuss coding issues and data-quality as required.
• Work and improve communication between clinicians and clinical coders to ensure they understand the coding process and its limitations, by meeting and liaising with relevant clinicians on a regular basis.
• Highlight issues relating to administrative coding discrepancies such as clinician or method of admission etc.
• Ensure coding queries are resolved, escalating to the Manager / Deputy Manager where necessary.
• Participate in discussions relating to general coding problems and issues, for example, at departmental meetings.
• Plan and prioritise own workload to meet performance and quality targets and, in a timely manner, advise the Manager / Deputy Manager of any hindrance to the achievement of these targets.
• Assist in the continuing development and improvement of the Clinical Coding Service in order that high quality data can be collected and produced with minimum delay.
• Advise the Manager / Deputy Manager on the standards of information provided for clinical coding, particularly if this becomes unacceptable; to evaluate and discuss with the manager any problems that arise, and assist in the implementation of any changes required.
• In periods of absence, cover the workload of other colleagues as required.
• Keep abreast of all new national guidance in relation to clinical-coding practices and ensure own coding skills are kept up to date, widening and strengthening own skill-set across various clinical specialties.
• Undertake appropriate training, as deemed necessary by the Training and Audit Manager and/or Clinical Coding Manager.
• Be aware of all statutory and local requirements regarding the disclosure/safe keeping of information e.g. the Data Protection Act, Caldicott etc.

Qualifications

• Please note the essential qualifications required for the post are outlined within the Person Specification.
• You are required to provide original evidence of the necessary qualifications for the post at interview should you be shortlisted.
• You will also be required to provide original copies as part of the pre-employment check screening.

Requirements

• For any new employees commencing employment with North Tees and Hartlepool NHS Foundation Trust, you will be subject to satisfactory completion of a 6 month probationary period.
• Please note that internal applications and individuals that are appointed to fixed term appointments of less than 6 months duration are exempt from the probationary period (unless you are an internal applicant currently part way through a probationary period or a bank member of staff).
• As part of our pre-employment screening process, all applicants are required to provide references covering their last three years employment history including any gaps.
• Applicants are requested to ensure e-mail addresses for all referees are included on their application form. Personal references are not acceptable.

Benefits

• If the hours advertised for the post are up to full time (37.5 hours per week), applications are still welcomed from individuals who may be seeking to work less than full-time hours and all requests will be considered in line with the post being appointed to for the successful applicant.

Company Description

• At University Hospitals Tees we want our workspaces to be places where everyone feels welcome, valued and safe.
• We treat people with respect, and we celebrate the differences that make each of us unique.
• We are here to support you throughout your application and at every stage of your career with us.
• We believe we work best when we collaborate, learn from each other and build teams that reflect the communities we serve.