Work Hours: 8-5 M-F
The HIM Coder position reviews, analyzes, and codes diagnostic and procedural information for hospital accounts. The primary function of this position is to perform ICD-10-CM, CPT, HCPCS, and ICD-10-PCS coding. The coding function is performed in compliance with established coding guidelines, third party reimbursement policies, government and state regulations, and accreditation guidelines. This position requires analytical skills and attention to detail. The HIM Coder will communicate in a professional manner with physicians and health system staff.
Education: Must possess a high school diploma or equivalent. Formal training in ICD-10-CM and ICD-10-PCS coding required.
Experience: A minimum of 3-5 years of hospital coding preferred. Experience with the 3M encoder preferred.
Licenses/Certification: Coding certification through AHIMA preferred. Must have CCS certification within 6 months of hire.
· Observes professional ethics in maintaining confidential information concerning the personal, financial, medical, or employment status of a patient of GVH and their families.
· Evaluates documentation, assigns, and sequences ICD-10-CM, CPT, and HCPCS codes for hospital outpatient health records and ensures the final diagnoses and operative procedures as stated by the physician are valid and complete.
· Evaluates documentation, assigns, and sequences ICD-10-CM and ICD-10-PCS codes for hospital inpatient health records and ensures the final diagnoses and operative procedures as stated by the physician are valid and complete.
· Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions.
· Performs a comprehensive review of the health records to ensure the presence of all component parts required according to the nature of the treatment provided.
· Assigns modifiers as appropriate.
· Maintains accurate coding according to established quality and productivity standards.
· Provides feedback and focused queries regarding incomplete or missing documentation clarification to appropriate staff and physicians.
· Reviews claims denials and rejections pertaining to coding and medical necessity issues and provides information to Supervisor for appropriate dissemination.
· Maintains coding accuracy rate of 95% per outside coding audits.
· Demonstrates commitment to professional growth through participation in professional organizations, workshops, educational programs, review of literature, in-services, and staff meetings.
· Cooperates with others in the health system to meet department and hospital requirements and goals.
· Communicates non-compliance or other issues to the HIM Supervisor in a timely and appropriate manner.
· Provides feedback to the HIM Supervisor to ensure the department processes are continually improving.
· Demonstrates motivation and accepts other duties as assigned by the HIM Supervisor.
· Participates in drills and emergency response training. May be called in for GVH disaster response.