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Trinity Health Coding Specialist - Health Information Management - Full Time - Days in Dubuque, Iowa

Employment Type:Full timeShift:Day Shift

Description:

Analyzes physician/provider documentation contained in assigned Routine Outpatient (RO ), Emergency department and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, and any procedures. Utilizes encoder software applications, which includes all applicable online tools and references) in the assignment of ICD diagnosis and procedure codes.

Assigns appropriate code(s) by utilizing coding guidelines established by:

• The Centers for Medicare/Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ICD-PCS Official Guidelines for Coding and Reporting

• American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification

• American Medical Association (AMA) CPT Assistant for CPT codes

• American Health Information Management Association (AHIMA) Standards of Ethical Coding

• Revenue Excellence/RHM Organization coding policies

ESSENTIAL FUNCTIONS:

  • Knows, understands, incorpo rates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.

  • Adheres to Trinity Health and RHM confidentiality requirements as they relate to the release of any individual or aggregate patient information.

  • Competently navigates the patient health record and other computer systems/sources in determination of appropriate diagnoses and procedures.

  • Codes Routine Outpatient health records , Emergency Department, and Outpatient Observation ( utilizing encoder software and online tools and refe rences in the assignment of codes ) .

  • Consults reference materials to facilitate code assignment.

  • Validates charges by comparing charges with health record documentation as necessary.

  • Understands appropriate link of diagnosis to procedure when applicable.

  • Appends modifier(s) to procedure or service code when applicable.

  • Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record.

  • Consults with CDI, physicians, or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous information .

  • Collaborates with Regional Shared Services (HIM and Patient Financial Services) in resolving billing and utilization issues affecting reimbursement.

  • Interprets bundling and unbundling guidelines (NCCI).

  • Interprets LCDs/NCDs and payer policies.

  • Tracks issues (i.e., missing documentation or charges) that require follow-up to facilitate coding in a timely fashion.

  • Investigates claims denials and/or appeals as directed.

  • Consistently meets or exceeds coding quality and productivity standards estab lished by Revenue Excellence .

  • Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.

  • Identifies concerns and responsible for providing resolution of moderate to complex problems. Notifies appropriate leadership for resolution when appropriate.

  • 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.

    MINIMUM QUALIFICATIONS

    (EDUCATION, LICENSURE, CERTIFICATION, AND EXPERIENCE REQUIRED):

  • 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.

  • Certified Coding Associate (CCA), Certified Procedural Coder Apprentice (CPCA), Certified Procedural Coder (CPC), Registered Health Information Technologist (RHIT), or Registered Health Information Administrator (RHIA) is required.

  • One (1) year of current coding experience is required. Current experience doing remote coding is a plus.

  • Current experience utilizing encoding/grouping software or CAC is preferred. Ability to utilize both manual an d automated versions of the ICD, CPT , and HCPCS coding classification systems is preferred.

  • 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.

  • Well-developed communication skills, both written and oral, that may be used either on-site or in virtual working environments. Able to communicate effectively with individuals and groups representing diverse perspectives.

  • Ability to work with minimal supervision and exercise independent judgment

  • Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload.

  • Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills. Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions. Ability to change and be flexible with work priorities. Strong problem-solving skills.

  • Must be comfortable functioning in a virtual, collaborative, shared leadership environment.

  • Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, v ision, goals, and values of Trinity Health.

  • 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.

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