Primary City/State:

Phoenix, Arizona

Department Name:

Revenue Integrity-Corp

Work Shift:

Day

Job Category:

Revenue Cycle

Primary Location Salary Range:

In accordance with Colorado???s EPEWA Equal Pay Transparency Rules.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position evaluates medical records and assigns appropriate clinical diagnosis and procedure codes in accordance with nationally recognized coding guidelines for professional and technical Radiation Oncology services.

CORE FUNCTIONS

1. Analyzes medical information from medical records. Accurately codes diagnostic and charge procedural and supply information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate assignments of ICD and/or CPT4 codes, MS-DRGs, APCs, POAs and reconciliation of charges.

2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, point of origin code, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysis, supervisor or individual department for clarification/additional information for accurate code assignment.

3. Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.

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4. Work all assigned billing edits related to radiation oncology professional or technical claims within Thrive claims.

5. ??As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.

6. Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT and MS-DRG codes according to national guidelines. May seek guidance for correct interpretation of coding guidelines and LCDs (Local Coverage Determinations).

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

MINIMUM QUALIFICATIONS

Associate's degree or technical degree or equivalent working knowledge.??

Must demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders Significant experience, typically gained through four plus years relevant work experience providing coding services within a broad range of health care facilities. Must be able to achieve an acceptable accuracy rate on the coding test administered by the hiring facility according to pre-established company standards.

Must be able to work effectively with common office software and coding software and abstracting systems. Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Radiation Oncology Certified Coder ROCC) in an active status is required.

PREFERRED QUALIFICATIONS

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist-Physician (CCS-P) with American Health Information Management Association or American Academy of Professional Coders is preferred. Will consider experience in lieu of certification/degree.

Additional related education and/or experience preferred.