Coding Specialist III - St. Mary's Hospital - ER Focused - Full Time Days - Remote
If you are looking for a career as a health care professional, where you are nurtured by collaboration and teamwork, open communication, and learning. We invite you to become part of an award winning health care system.
Quality of Life: Where career opportunities and quality of life converge
Advancement: Strong orientation program, generous tuition allowance and career development
Work/Life: Positions and shifts to accommodate all schedules
We offer great Benefits including: Competitive Pay, Paid Leave. Shift Differentials, just to name a few.
- Analyzes physician/provider documentation contained in assigned health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures.
- Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of
- Internal Classification of Diseases,
- Clinical Modification diagnosis and procedure codes, and
- Current Procedural Terminology / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers.
- Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA) Coding Clinic, American Medical Association (AMA) for CPT codes and CPT Assistant, American Health Information Management Association (AHIMA) Standards of Ethical Coding, Revenue Excellence/Regional Health Ministry (RHM) coding policies and CHE Trinity Health Coding Manual (TBA).
- Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
- Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs.
- Codes Complex Outpatient or Inpatient utilizing encoder software and online tools and references, in the assignment of ICD-9-CM, ICD-9-PCS, CPT-4, HCPCS codes, MS-DRG, POA, SOI & ROM assignments, APC assignment and all required modifiers.
- Validates charges by comparing charges with health record documentation as necessary.
- Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record.
- Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialists (CDIS) regarding documentation issues or needs related to Inpatient coding.
- Collaborates with Regional Shared Services (HIM and Patient Financial Services) in resolving billing and utilization issues affecting reimbursement.
- Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems.
- Tracks issues (i.e., missing documentation, charges or Inpatient queries that require follow-up to facilitate coding in a timely fashion.
- Consistently meets or exceeds coding quality and productivity standards established by URO/MO.
- Adheres to Trinity Health and Ministry Organization confidentiality requirements as they relate to the release of any individual or aggregate patient information.
- Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
- Performs other duties as assigned by leadership.
- Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
1. Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate's degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required. Bachelor's degree in Health Information Management (HIM) or related healthcare field is preferred.
2. Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technologist (RHIT), or Registered Health Information Administrator (RHIA) is required.
3. Two years of current acute care coding emergency department and observation or physician coding experience is required.
Two (2) years of current Complex Outpatient or Inpatient coding experience is required. Three (3) to five (5) years of current Complex Outpatient or Inpatient coding experience preferred. Current experience doing remote coding is a plus.
4. Current experience utilizing encoding/grouping software or CAC is preferred. Ability to utilize both manual and automated versions of the ICD and CPT coding classification systems is preferred.
5. Ability to use a standard desktop and windows based computer system, including a basic understanding of e-mail, internet, and computer navigation. Ability to use other software as required to perform the essential functions on the job. Familiarity with distance learning or using web-based training tools desirable.
Please be aware for the safety and security of our colleagues and patients all new employees are required to undergo and pass all applicable state and federally mandated pre-employment screening requirements including:
- Relevant Background Checks
- Drug Screen
- PPD / Tuberculosis Test
- Reference Check
- COVID Vaccination
.Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.