Job Description

Under the direction of the System Director of Health Information Management monitors coding and reimbursement activities with respect to the EMHR clinics. Codes are to be used for diagnosis, procedure and physician indexing, statistics, trend analysis and reimbursement purposes. Exhibits the F.I.R.S.T. values (Friendliness, Innovation, Respect, Service, and Trust).

ESSENTIAL FUNCTIONS, DUTIES AND RESPONSIBILITIES:

1. Reviews and analyzes codes submitted from physicians. Applies the appropriate ICD-10-CM code and/or CPT code to clinic charts by abstracting pertinent information from patient records and applying coding guidelines.
2. When needed, use the encoder to ensure appropriate codes and modifiers have been applied. Reviews all edits within encoder to resolve any delays in billing from a coding perspective.
3. Works delinquent accounts to ensure that deadlines for documentation are met for reporting requirements.
4. Distributes coding information to appropriate personnel. 5. Works closely with the business office staff to help resolve any coding related issues.
5. Demonstrates a commitment to professional accountability and growth to maintain and expand knowledge and skills by attending educational opportunities and staying current with significant changes in coding procedures and regulations.
6. Review and work Quadex claims in a timely manner to avoid delays in billing.
7. Works independently, bringing identified concerns to the supervisor for resolution.
8. Considers the age and demographics of the patient served, applies knowledge of growth and development and age specific techniques through the lifespan (neonates/infants, pediatrics, adolescents, adults and geriatric patients) in planning and implementing care.
9. Maintains confidentiality by adhering to all HIPAA guidelines and Ephraim McDowell Health policies related to HIPAA.
10. Contributes to the achievement of the mission and philosophy of the Organization.
11. Contributes to the effective operations of the Organization by demonstrating dependability in job performance.
12. Demonstrates a commitment to incorporating the core concepts of patient family centered care into practice (dignity, respect, information sharing, and participation).
13. Demonstrates a commitment to the development and implementation of shared governance across the Organization.
14. Performs other related duties as assigned.

WORKING CONDITIONS, HAZARDS AND PHYSICAL EFFORT:

Works in a typical office setting. Must be able to work under pressure and meet deadlines. May require working evening and weekend shifts with overtime as necessary. Ability to work in a stationary position and move medium weight files under 10 lbs. The tasks of this job do not involve exposure to blood, body fluid or tissue. The responsibilities of this position are not subject to a specified number of work hours but rather a flexible schedule based on meeting volume requirements and departmental director’s approval. May be able to work remotely with occasional on-site responsibilities.

CONTACTS WITH OTHERS:

Contact with most all Organization Associates, providers, patients, visitors, vendors, insurance carriers, and clinic Associates.

EQUIPMENT USED/SPECIAL SKILLS REQUIRED:

Personal terminals, calculators, PC and printers, and copier, excellent communication skills. In-depth knowledge of coding practices and third-party payor requirements.

Qualifications

One year of coding experience or charge entry experience required.