Offer summary

Qualifications:

Associate degree in health information technology or completion of a coding certification program., Five years of coding optimization experience in an acute care facility., Strong understanding of medical terminology, anatomy, and clinical documentation., Coding specialist certification is required..

Key responsabilities:

Perform coding quality reviews on inpatient and outpatient records to ensure compliance with coding mandates.

Conduct retrospective coding audits and validate coding accuracy before bill submission.

Provide training for coding staff and educate healthcare professionals on coding guidelines and documentation techniques.

Prepare reports on coder accuracy results and monitor coding staff for compliance with ethical standards.

Job description

Summary

Ensures accurate coding and

data quality creating consistency and efficiency in inpatient and/or

outpatient services through ongoing performance of ICD-10-CM and/or CPT coding

validation and accurate MS DRG APR DRG and/or outpatient APC.

Responsibilities

Performs coding quality reviews on inpatient records to

validate the ICD-10-CM codes DRG group appropriateness missed secondary

diagnoses and procedures and ensures compliance with all DRG mandates and

reporting requirements. Ensures

validity of data prior submission of bill. Performs retrospective coding audits

as required.

Performs data quality reviews on outpatient encounters to

validate the ICD-10-CM CPT and HPCS Level II codes modifier assignments APC

group appropriateness missed secondary diagnosis and procedures and ensure

compliance with all outpatient coding mandates.

Ensures medical necessity criteria is met and local medical review

polices are followed.

Continuously evaluates the quality of the clinical

documentation to spot incomplete or inconsistent documentation for inpatient

encounters that impact code selection and resulting DRG groups and

payments. Brings identified concerns to

department manager for resolution.

Provides training for coding staff and educates facility

healthcare professionals in the use of coding guidelines and practices proper

documentation techniques medical terminology and disease processes as it

relates to the MS DRG APR DRG and/or outpatient APC and other clinical data

quality management. Maintains knowledge of current professional coding

certification requirements.

Reviews LifeChart coding validator coding error and CED

work queues. Identifies any coding or coding related charge issues to

leadership. Performs routine coding validation audits. Prepares reports for director on coder

accuracy results.

Abides by the Standards of Ethical Coding as set forth by

the American Health Information Management Association and monitors coding

staff for violations and reports to Coding Manager when areas of concern are

identified.

Provides direction to coding staff in absence of management.

Other Information

BASIC KNOWLEDGE:

Associate degree in health information technology

(preferably with RHIT) and/or successful completion of coding certification

program. Understanding of the content of

the medical record. Trained in medical

terminology medical science disease processes anatomy and physiology. Ability

to recognize and understand clinical documentation pertinent for coding. Good writing skills to prepare compliant physician

queries. Computer literate; capable of

researching websites to access regulatory requirements. Ability to navigate the patient electronic

medical record. Coding specialist

certification required.

Experience

Five years coding optimization experience in an acute care

facility. Past auditing experience or

strong training background in coding preferred.

Working Conditions And Physical Requirements

After orientation at the hospital�s facilities work is

performed at the employee�s residence in accordance with provisions of a

telecommuting work agreement to which the employee has agreed as a condition

of working in an off-campus location.

The hospital�s normal office and central work location environment

applies for assignments meetings and other requirements as determined by

department management.

Independent Action

Performs independently within the department�s policies and

procedures. Refers specific complex

problems to the supervisor when clarification of the departmental policies and

procedures are required.

Supervisory Responsibility

None.

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: Brown University Health Corporate Services USA:RI:Providence

Work Type: Full Time

Shift: Shift 4

Union: Non-Union

Required profile