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.

NON-EXEMPT

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.

Professional Requirements:

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.