Job description
Overview:
Patient Interaction: No Contact
HIPAA: This position will have access to the following Protected Health Information in order to carry out the duties related to their position at HaysMed based on the following criteria: Primary - required (routine) to do the job Secondary - required for the job, but mostly be exception None - no approved access Description of Information Level Primary: Patient Demographic Information (information used to identify a person): Name, Date of Birth, Address, Race, Marital Status, Religion Financial Information/Insurance (information related to insurance, billing and payment): Billing Information, Payer Name, Payer ID, Account Balances, Plan Elements Covered, Payment Information, Payment Rates Clinical Information (information that describes a patient's health status): Diagnosis, Reports/Medical Notes, Test Results, Problem List, Procedures, History and Physical Coding Information (clinical information that is in (alpha) numeric format): ICD-9 Codes, ICD-10-CM , ICD-10-PCS, Rev Codes, CPT Codes. Qualifications:
Analyzes medical records in order to code and abstract medical information to be submitted to financial reimbursement as required for the Uniform Bill and for the DRG/Prospective Payment System. Requires Registration and/or Certification as an Registered Health Information Administrator (RHIA), an Registered Health Information Technologist (RHIT), or Certified Coding Specialist (CCS). Must be proficient in both ICD-9-CM and ICD-10-CM and ICD-10PCS, and CPT.
Position Summary:
- Reads and reviews medical records, identifies appropriate diagnosis and procedure and assigns appropriate code.
- Completes data entry for abstract and/or billing system.
- Queries/contacts physicians when code assignments are not straight forward or documentation in the record is insufficient, ambiguous, or unclear for coding purposes.
- Notifies patient accounts and/or CBO of coding and/or DRG changes.
- Monitors unbilled accounts and notifies the appropriate department or clinic to resolve issues.
- Code utilizing the encoder and the Computer Assisted Coding (CAC) software.
- Works closely with the Clinical Documentation Improvement department.
Infection Control: Initial and Ongoing training in dealing with infection control. Trainings could include but are not limited to, blood borne pathogens, bodily fluids and bio hazardous materials as it applies to your daily work environment.
Patient Interaction: No Contact
HIPAA: This position will have access to the following Protected Health Information in order to carry out the duties related to their position at HaysMed based on the following criteria: Primary - required (routine) to do the job Secondary - required for the job, but mostly be exception None - no approved access Description of Information Level Primary: Patient Demographic Information (information used to identify a person): Name, Date of Birth, Address, Race, Marital Status, Religion Financial Information/Insurance (information related to insurance, billing and payment): Billing Information, Payer Name, Payer ID, Account Balances, Plan Elements Covered, Payment Information, Payment Rates Clinical Information (information that describes a patient's health status): Diagnosis, Reports/Medical Notes, Test Results, Problem List, Procedures, History and Physical Coding Information (clinical information that is in (alpha) numeric format): ICD-9 Codes, ICD-10-CM , ICD-10-PCS, Rev Codes, CPT Codes.
Required:
- Previous coding experience
- Additional certification may be required for certain patient care settings or populations.
Preferred:
- Associate degree
- Anatomy and physiology and medical terminology courses.
- Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) or Registered Health Information Administrator (RHIA) certification or American Academy of Professional Coders (AAPC).
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