Sr, Coding Specialist - HIM Job Listing at Baton Rouge General in Baton Rouge, LA (Job ID 1912880232)

Description

JOB PURPOSE OR MISSION: Assigns diagnostic and procedure codes to records of completed Imaging exams and/or discharged patients and coordinates the follow-up on deficient/delinquent discharge records, under the direction of a senior level employee. Performs duties appropriate to the need of the age population served, as defined in the department's scope of service.

PERFORMANCE CRITERIA

CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.

PERFORMANCE STANDARDS:

· Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.

· Takes initiative in living our Everyday Excellence values and vital signs.

· Takes initiative in identifying customer needs before the customer asks.

· Participates in teamwork willingly and with enthusiasm.

· Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.

· Keeps customers informed, answers customer questions, and anticipates information needs of customers.

CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines, and the GHS Corporate Compliance Guidelines.

PERFORMANCE STANDARDS

· Practices diligence in fulfilling the regulatory and legal requirements of the position and department.

· Maintains accurate and reliable patient/organizational records.

· Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.

CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.

PERFORMANCE STANDARDS

· Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.

· Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.

· Upholds the ethical standards of the organization.

CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.

PERFORMANCE STANDARDS

· Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.

· Initiates or redesigns to continuously improve work processes.

· Contributes ideas and suggestions to improve approaches to work processes.

· Willingly participates in organization and/or department quality initiatives.

CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.

PERFORMANCE STANDARDS

· Effectively manages time and resources

· Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.

· Consistently looks for and uses resource saving processes

CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.

PERFORMANCE STANDARDS

· Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.

· Employee proactively reports errors, potential errors, injuries or potential injuries.

· Employee demonstrates departmental specific patient and employee safety standards at all times.

· Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.

· Consistently looks for and uses resource saving processes

JOB FUNCTIONS

ESSENTIAL JOB FUNCTIONS include, but are not limited to:

1. Identifies and codes discharge records for the purpose of reimbursement, research

JOB FUNCTIONS

ESSENTIAL JOB FUNCTIONS include, but are not limited to:

1. Identifies and codes Imaging records for the purpose of reimbursement, research and compliance with federal regulations according to diagnosis, operation, and procedure

PERFORMANCE STANDARDS:

· Codes or adds modifiers, if needed, to all Imaging records within three business days of discharge/exam completion 98% of the time for all Imaging locations

· Maintains a coding accuracy rate of 95%.

· Demonstrates a complete understanding of all procedures concerning the sequencing of diagnoses, operations or procedures.

· Codes Imaging accounts in order of priority as assigned by the highest dollar amount and most delinquent dated account.

· Inputs data into computerized system.

· Runs or receives and works the Imaging accounts on daily statistical reports, including, but not limited to:

- Patient Care Charge Errors by Patient

- Patient Detail Transactions Audit for each Imaging location

- Paragon Unbilled Report

· Enter charges for all Imaging exams performed by contract companies (i.e. Vascular Associates Laboratory (VAL)) and correlate with the end-of-the-month reports.

· Work in conjunction with various other departments, including: Business Services, Health Information Management, Revenue Integrity, and Patient Financial Services to resolve issues with patient's billing/coding.

· Works in conjunction with other personnel to help expedite needed orders with the correct CPT code(s), preauthorization, insurance verification, and financial counseling for patients, if needed.

· Codes outpatient encounter forms for billing purposes and data retrieval.

2. Follows up on deficient and delinquent Imaging accounts to assure compliance with Medicare, Medicaid, Insurance Companies and departmental rules and regulations.

PERFORMANCE STANDARDS:

· Requests information on diagnoses or procedures from physicians when not recorded on account.

· Identifies deficiencies important for coding purposes.

· Audits and completes incomplete Imaging accounts and charges that have been identified for deficiencies and provides feedback to supervisor.

· Investigates and adds missing charges and notifies supervisor of results

· Demonstrates a thorough working knowledge of the medical coding systems.

· Maintains control procedures to assure accuracy and completeness of coded information.

3. Performs all other duties as assigned.

EXPERIENCE REQUIREMENTS

Six years inpatient and outpatient Medicare coding experience preferred; certification/registry (listed below) accepted in lieu of experience

SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS

(CCS) Certified Coding Specialist, (CPC) Certified Professional Coder (AAPC), (RHIT) Registered Health Information Technician or (RHIA) Registered Health Information Administrator, preferred. (RCS) Radiology Coding Specialist, required.

HIPAA REQUIREMENTS:

Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: Medical records w/out limitation both paper and electronic, patient demographics, patient information related to surgery or appointment schedules, information related to patient location, religious beliefs, lab or radiology results.

SAFETY REQUIREMENTS:

Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: Incident reporting, personal protective equipment (PPE), exposure control plans, hand washing, and environment of care.