Address
Form of workJOB SUMMARY:
EXPERIENCE/QUALIFICATIONS:
EDUCATION:
LICENSURES/CERTIFICATION:
DUTIES AND RESPONSIBILITIES ( These are the essential job functions for this position. The essential functions of this job include, but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential function of this job without imposing significant risk of substantial harm to the health or safety of themselves or others) :
The following job accountabilities are not unique to this particular job but are common to all jobs at VPH:
WORK ENVIRONMENT:
PHYSICAL DEMANDS:
Continuous 66 to 100 % of time
Frequent 33 to 65% of time
Occasional 0 to 32% of time
1. Clerical/Administrative Patient Care
Salary Range: $38.10 - $51.23 per hour
- The Coder II is responsible for the timely and accurate assignment of diagnosis and procedures utilizing ICD 10 CM/PCS, HCPCS and CPT-4 coding classification systems. Applies knowledge of anatomy, physiology, medical terminology, disease processes and pharmacology. Applies knowledge of reimbursement, DRG and APC systems. Use an encoder and demonstrates tested data quality and data integrity skills. Clinical data are used for a variety of purposes including but not limited to reimbursement, credentialing, decision support, planning, marketing, contracting, budgeting, quality evaluation, i.e. Data is also reported to a variety of state and federal regulatory agencies. Data must be of the highest quality and accuracy possible, reflecting precisely each episode of care. The data abstracted from the medical record is entered into the hospital computerized abstracting system in order to support the needs identified. Duties must be accomplished according to the established internal and industry standards of accuracy and production.
EXPERIENCE/QUALIFICATIONS:
- 3 years of current coding and abstracting experience in inpatient services utilizing, ICD 10 and CM/PCS coding classifications.
- Demonstrate ability to understand and correlate the clinical content of a health record.
- Demonstrate the skills of working with Electronic Health Records, encoder, abstracting tools and different utilization systems: MS-DRG, APR-DRG (California) and APC.
- Demonstrate the understanding of coding practices, ICD conventions, Official Coding Guidelines, CMS IPPS & OPPS rules, AHA Coding Clinic, HIPAA and other regulatory and compliance documents.
- Technical aptitude for working with basic to intermediate PC hardware and software applications. Solving simple computer problems and ability to perform basic troubleshooting. Proficient with Word, Excel, Outlook and other healthcare and business applications.
- Strong communication skills on the phone and in writing.
EDUCATION:
- Minimum associate college degree or equivalent
- Completion of a Coding Certification program from an accredited program with classes in medical terminology, anatomy and physiology, ICD-10/CM and PCS coding conventions and disease process required
LICENSURES/CERTIFICATION:
- CCS required
- Additional AHIMA, AAPC and ACDIS credentials or certifications preferable
- Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment
DUTIES AND RESPONSIBILITIES ( These are the essential job functions for this position. The essential functions of this job include, but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential function of this job without imposing significant risk of substantial harm to the health or safety of themselves or others) :
- Code diagnoses and procedures according to accepted ICD-10 CM/PCS, conventions, official coding guidelines, CMS/MediCal and state regulations, hospital policies and standards for Inpatients, Observations, Same Day Surgery, Emergency Department and other outpatient services.
- Maintain an acceptable level of productivity based on internal and industry standards, with an accuracy of at least 95% (subject to change based on national and local standards).
- Ensure optimal reimbursement through timely, accurate and compliant coding and correct DRG/APC assignment, with maintenance of 95% or more accuracy in DRG/APC assignment (subject to change based on national and local standards).
- Assign applicable modifiers and correct all the edits for assigned codes/modifiers based on CMS NCDs, LCDs, NCCI, MUE and other payer edits.
- Abstract assigned records in a timely manner with an accuracy of at least 98%.
- Extract clinical and demographic information from the medical records, using EHR and abstract data base in accordance with established internal policies and procedures and in accordance with State and Federal discharge data collection requirements and regulations.
- Assist in data collection, retrieval, analysis and submission projects and in timely and accurate OSHPD MIRCal discharge data reporting.
- Assist and collaborate with financial services and revenue integrity team for timely, accurate and compliant submission of the bills to federal, state and local payers.
- Assist and communicate with CDI (clinical documentation integrity) specialists in identifying post discharge opportunities for documentation clarification, SOI or DRG improvement, risk adjustment or correct quality indicators capture.
- Assist Quality department in data collection, analysis and reporting.
- Communicate and clarify with health care providers concerning diagnoses and procedures when necessary.
- Participate/report in the departmental meetings, huddles, conferences; stay up-to-date with new industry changes; maintain professional certifications; participate in organized trainings or educational venues.
- Respond in a timely manner to the correspondence, based on department policies and procedures.
- Assist or perform other duties assign by Coding Services Management.
The following job accountabilities are not unique to this particular job but are common to all jobs at VPH:
- Complies with VPH policies and procedures on customer satisfaction and service excellence. Demonstrates professionalism and cultural sensitivity in coordinating activities and communicating with all customers, peers, and the community at large. Conducts self in a professional, respectful and courteous manner during all interactions. Works effectively and collaboratively with others toward common goals.
- Communicates accurately, honestly, supportively and in a timely manner with department and interdepartmental team members. Demonstrates effective business writing and oral communication skills, handwriting is clear and legible.
- Participates in operational aspects of the department, and maintains/participates in performance improvement activities within the department.
- Participates in all departmental specific training, Environment of Care (injury/illness prevention, fire/life safety, hazardous materials, emergency preparedness, utilities management, medical equipment management, safety and security management), infection control (standard precautions, TB Exposure Control Plan, Bloodborne Pathogen Exposure Control Plan).
- Demonstrates knowledge of and follows safety practices. Understands the importance of safety, including patient safety in the work place. Maintains a safe environment for self and others.
- Actively participates in the Patient Safety Program, including event reporting. Identifies sentinel events/near misses and responds per defined organization processes. Participates in education activities and process implementation. Demonstrates advocacy for the patient/customer and appropriately acknowledges patients, customers and visitors.
- The above statements reflect the essential functions considered necessary to describe the principle content of the job. They are not intended to be a complete statement of all work requirements or duties that may be inherent in the job.
WORK ENVIRONMENT:
- Primarily an inside building/office environment, well lighted and ventilated, which may consist of multiple treatment and/or work sites.
- Fast and continuous work pace with variable workload.
- Frequent contact with staff and public under a variety of circumstances. Requires ability to communicate clearly (in English) verbally and in writing for effective communication with other staff members, physicians, vendors, community members, patients and patient families, employees and applicants of all socio-economic levels from a diverse cultural and ethnic population.
- Subject to many interruptions from multiple calls and inquiries and potentially emotional situations involving accidents, injuries, illness and/or death.
- Handles emergency/crisis situations in accordance with Hospital policy.
- Answers phones or pages; may carry a beeper/pager, and/or use a two-way radio.
- Occasional travel may be required.
- Potential risk of exposure to hazards from chemicals (toxic and non-toxic), flammable materials, gas or electrical or radiant energy or equipment with/without moving parts.
PHYSICAL DEMANDS:
Continuous 66 to 100 % of time
Frequent 33 to 65% of time
Occasional 0 to 32% of time
1. Clerical/Administrative Patient Care
- Frequent sitting and standing/walking with frequent position change.
- Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
- Occasional/intermittent reaching at or above shoulder level.
- Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.
- Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
- Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.
Salary Range: $38.10 - $51.23 per hour
