The Coding Specialist III is responsible for the accurate coding and assignment of Classification of Diseases, 9th Clinical Modification (ICD-9-CM) and/or Classification of Diseases, 10th, Clinical Modification (ICD-10-CM) and International Classification of Diseases Procedure Coding System (ICD-10-PCS) codes, Current Procedural Terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes to inpatient and outpatient medical records for billing and statistical reporting. Coding is done in compliance with American Hospital Association (AHA) Coding Clinic Guidelines and the Centers for Medicare and Medicaid Services (CMS). This position is responsible for abstracting data from medical records in accordance with the Uniform Hospital Discharge Data Set (UHDDS), CMS and Bon Secours Health System requirements.
Assigns and enters on automated systems diagnosis and procedure codes according to the ICD-9-CM and/or ICD-10-CM and ICD-10-
PCS and AHA Coding Clinic Guidelines with an accuracy of 95%.Abstracts data according to Uniform Hospital Discharge Data Set (UHDDS) and specific requirements.
Interacts with Clinical Documentation Management Program personnel regarding documentation issues for coding and DRG assignments to ensure Case Mix Index (CMI) accuracy.
Contacts appropriate personnel (e.g., physician, nurse practitioner, etc.) as necessary regarding documentation of diagnosis and/or procedure.
Reviews and monitors coding and billing reports, and communicates to the System Coding Manager and/or Administrative Director of HIMS in a timely manner.
Supports compliance activities identifying areas of high risk in coding and documentation practices.
Reviews and responds to coding inquiries and denials.
Attends educational sessions and reviews of publications to keep current on changes and developments.
Collects and analyzes productivity data for the areas of responsibility.
Assists training of departmental staff and volunteers as needed.
Acts as liaison with other health system personnel, medical staff members, physicians, office personnel, and vendors as appropriate, and attends departmental meetings.
Minimum three to five (3-5) years coding experience in an acute healthcare setting. Experience in a hospital/medical center preferred. Experience with computerized encoders and abstracting systems required. Experience with monitoring the discharged not final billed report preferred. Certified Coding Specialist (CCS) required. Working knowledge of ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT, HCPCS, Diagnostic Related Groups (DRGs) and AHA Coding Clinic Guidelines required. ICD-9-CM, ICD-10-CM, ICD-10-PCS courses. Strong interpersonal communication skills both verbal and written; problem identification and analysis evaluation of medical records. Requires high level of accuracy and attention to detail, to include accurate data entry skills. Previous experience with 3M Encoder systems preferred.
A high school diploma or equivalent.
If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.
Good Samaritan Hospital
Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the area's leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Children's Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.
WMCHealth is a 1,900-bed healthcare system headquartered in Valhalla, New York, with ten hospitals on eight campuses spanning 6,200 square miles of the Hudson Valley. WMCHealth employs more than 12,000 people and has nearly 3,000 attending physicians. From Level 1, Level 2 and Pediatric Trauma Centers, the region’s only acute care children’s hospital, an academic medical center, several community hospitals, dozens of specialized institutes and centers, a state of the art Telemedicine program, skilled nursing, assisted living facilities, homecare services and one of the largest mental health systems in New York State, today WMCHealth is the pre-eminent provider of integrated healthcare in the Hudson Valley.