The role of home health coder requires individuals who have a high level of technical competence and a willingness to assume responsibility and accountability for autonomous practice. The coder must have a thorough understanding of current coding practice and OASIS assessment sequencing to ensure that the diagnosis and coding accurately reflect the patient's plan of care ensuring that the agency's payments are not denied, delayed, or misrepresented.
DUTIES AND RESPONSIBILITIES:
Code all home care assessments (start, resumption, and recertification assessments) thoroughly and accurately following home care coding regulations and guidelines regarding sequencing of primary, secondary, and manifestation codes. Records are to be coded within one business day of receipt
Reviews medical record thoroughly to ascertain all diagnoses/procedures.
Consult with admitting clinician regarding any discrepancies in coding diagnosis, sequence, or severity.
Contacts responsible physician in a professional, tactful manner, if diagnosis is not available on medical record.
Refers medical record to either Manager or Director of Clinical Services If there is a question regarding the diagnoses/codes.
Utilizes analyzing software to ensure diagnoses accurately reflect current assessment data
Codes all diagnoses/procedures in accordance to ICD-10-CM coding principles and the Coding Manual.
Meets quality standards of having 95% of principal diagnoses and procedures appropriately and/or correctly coded.
Maintains the number of HHRG coding changes below the 3% quarterly per PRO threshold.
Reviews coding periodicals within seven (7) days of receipt.
Updates the Coding Manual on an ongoing basis.
Notifies manager or director whenever work is more than 48 hours behind work deadline.
Ensures data quality and optimum reimbursement allowable under the federal and state payment systems.
Acts as a resource person to home health staff for coding and may provide education regarding coding changes/issues.
Must be familiar with all medical record and home health coding requirements.
Maintains a good working relationship within the department, other departments and medical staff.
Willing to accept additional assignments.
Performs performance improvement functions through data collection and documentation review.
Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations.
Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict.
Adheres to dress code.
Completes annual educational requirements.
Maintains regulatory requirements.
Wears identification while on duty.
Maintains confidentiality at all times.
Attends department staff meetings as required within the department.
Reports to work on time and as scheduled; completes work in designated time.
Represents the organization in a positive and professional manner.
Actively participates in performance improvement and continuous quality improvement (CQI) activities.
Coordinates efforts in meeting regulatory compliance, federal, state and local regulations and standards
Communicates and complies with the Benefis Health System Mission, Vision and Values as well as the focus statement of the department.
Complies with Benefis Health System Organization Policies and Procedures.
Complies with Health and Safety Standards and Guidelines.
High School graduate or equivalent.
Knowledge of diagnoses/procedures in accordance with ICD-10-CM coding principles for home health care.
Ability to work with physicians and clinicians in a collaborative manner.
Proven organizational and general office skills. Ability to operate business machines and computers (i.e.: calculators, phones).
Must possess sufficient oral and written communication skills to assist with customer service and communicate effectively with other staff members and departments.
Basic knowledge of Medicare, Medicaid, and third party insurances.
Knowledge of billing and collection techniques.
Knowledge of home health conditions of participation
As a not-for-profit community health system, Benefis is driven to provide the highest level of care. We serve nearly 230,000 residents across a 15-county region that is bigger than Connecticut, Massachusetts, New Hampshire and Vermont combined. Benefis is the largest non-governmental employer in the Great Falls area, with more than 3,000 employees. Benefis has 530 licensed beds (that includes 146 beds in long-term care, 71 in assisted living and 20 beds at Peace Hospice of Montana) and partners with over 250 area physicians.
Our hospital has been recognized for its exceptional work in quality care by providing a wide range of programs and services to help you live the best life possible. We’re here to help you “Live well.”
Benefis Health System came about when two Christian-based hospitals became one. Our founders believed in providing good care to all in need, and trusted that this would be accomplished. The Benefis name was derived using Latin root words: "Bene-" meaning good, and "fis-" for faith and trust. It’s these same root words that make up such terms as ‘beneficial’ a...nd ‘confidence'. Benefis has been a trusted provider of care for more than 125 years. And our name speaks to our commitment: good care one can put faith in.
Benefis is consistently ranked among America’s top hospitals by the nation’s leading healthcare ratings organizations for a range of services, including cancer care, joint replacement, stroke treatment, wound care and home health.
To learn more about our services, continue looking through our website at WWW.BENEFIS.ORG or call 406.455.5000.