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Form of workJob Description
Job Description
JOB SUMMARY
Provide the advanced Inpatient Coding skills necessary for the coding of all diagnoses and procedures and to ensure optimal DRG assignment after a thorough review of medical record.
JOB DUTIES AND RESPONSIBILITIES
Job Specific:
1. Reviews the complete inpatient medical record documentation to identify and code all diagnostic and procedural information using the ICD-10-CM/PCS classification system, not to exceed a bill hold status of three (3) days post the date of discharge.(EF)
2. Maintains productivity standard for assigned work type with a minimum of 95% accuracy: (EF)
a. Observation Charts = 5/hour
b. Emergency Department = 15/hour
c. Outpatient Testing= 30/hour
d. Ambulatory Surgery = 5/hour
e. Inpatient= 2.5/hour
3. Assigns ICD-10-CM/PCS codes with accuracy, ensuring that all assigned codes have adequate physician documentation to support.(EF)
4. Works collaboratively with Providers, Clinicians, and Clinical Documentation Improvement Specialists to provide analysis of documentation for clinical support of diagnoses/quality indicators.
5. Identifies patient safety errors within the electronic medical record (i.e. wrong encounter, wrong patient, wrong patient type, scanning errors, physician documentation, errors).
6. At the start of each day, review your virtual and coding worklists in Optum to prioritize work.
7. Maintains a working knowledge of the ICD-10-CM/PCS Official Guidelines for Coding and Reporting, AMA Coding Clinic advice for accurate code assignment and all applicable Federal, State, and Local laws and regulations.(EF)
8. Must be able to demonstrate knowledge of reimbursement (Medicare and Medicaid) principles and methodologies and must have a working knowledge of the compliance guidelines related to coding and billing.(EF)
9. Works independently in coding as a remote employee. Troubleshoots and assists analysis of system issues independently with IT assistance.
10. Understands computer systems, and possesses the ability to reconcile various accounts, charges, including correct discharge dates, and requesting billing to link account as necessary.
11. Utilizes Optum computer-assisted coding and encoder to assign correct ICD-10-CM/PCS codes for the diagnoses and procedures abstracted from the medical record documentation.
12. Approve the code assignment by sending account to billing.(EF)
13. Completes query for documentation clarification from physician when needed.
14. Assists on-site at hospital when supervisor out of office for more than two consecutive days.
15. Assists Coding Supervisor with the provision of training to new staff.
16. Assists Coding Supervisor with the appeals process for DRG changes/denials.
Hospital:
1. Adheres to organization-wide, HIM, HIM coding and other applicable policies and procedures.
2. Day-to-day performance in compliance with the hospital’s Service Excellence Behavioral Expectations.
3. Performs within the prescribed limits of the hospital’s Ethics, Compliance and Confidentiality Program guidelines.
4. Performs within his/her professional Scope of Practice at all times.
Other Duties As Assigned:
- Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time
Job Requirements
EDUCATIONAL REQUIREMENTS
Required: Associates degree in a health-related field OR a graduate from a Medical Coding course from a recognized college, major university, or technical program.
Preferred: Bachelors degree in a health related field.
EXPERIENCE
Required: At least one (1) year Inpatient Coding experience in an acute care facility.
Preferred: At least three (3) years Inpatient Coding experience in an acute care facility.
Special Skills and Abilities:
Required: Advanced ICD-10-CM/PCS coding knowledge and scoring a minimum of 80% on pre-employment coding test.
Preferred: Advanced ICD-10-CM/PCS coding knowledge and scoring a minimum of 95% on pre-employment coding test.
LICENSURE / CERTIFICATION REQUIREMENTS
Required: Certified Coding Specialist (CCS)
Preferred: Certified Coding Specialist (CCS)
COMPANY PROFILE
Citizens Medical Center is a not-for-profit, community hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 317-bed acute care hospital with over 1,200 employees. Voted “Best of the Best” hospital in Victoria for 13 consecutive years, Citizens Medical Center is a level III Trauma Center, with a newly renovated 24/7 Emergency Department that includes an onsite medical helicopter. Citizens has a comprehensive Community Cancer Program that includes two linear accelerators and HDR brachytherapy. Citizens is recognized for its outstanding cardiology program which includes a nationally accredited Chest Pain Center and is a Primary Stroke Center. Citizens also includes a comprehensive, accredited Bariatric Surgery program, Birth Center with labor and delivery, an imaging and surgery center, sleep study center, state-of-the-art rehabilitation and fitness center, urology center and daVinci robotics minimally invasive surgery options, a home health agency, and has a long history of providing continuing education for healthcare providers and the community.
Citizens Medical Center is looking for employees who actively demonstrate service excellence by exemplifying our iCare values. If you are someone who displays respect and enthusiasm for patients, visitors, and coworkers while consistently upholding the hospital’s commitment to providing outstanding outcomes, service excellence, and fiscal responsibility, then you could be a good fit for the CMC team!
