ED Coder/Certified
- Assigns codes accurately to each record for diagnoses and procedures performed according to ICD-9-CM and CPT-4 coding and classification systems
- (This includes assignment of “modifiers” on required cases).Utilizes resources needed to adhere to coding guidelines (e.g
- Coding Clinic, Coding Handbook, etc.)
- Also uses reference materials (medical dictionary, Physicians Desk Reference, approved abbreviations) to ensure accuracy to align with Coding Compliance Regulations (Department of Justice/OIG).Abstracts data from the medical record and enters data directly into the 3M Application software
- (Utilizes data sheet only when needed during downtime)
- Responds correctly to prompts for refining of codes as well as tracking case managed patients, readmission status, discharge disposition, birth weight, O.R
- minutes, lesion size, type of anesthesia and ASA classification..Obtains corresponding pathology reports to ensure accurate coding to support documentation within the record
- Works in concert with DRG Validator on “DRG Assurance”
- Verifies proposed DRG to ensure accurate assignment for direct relationship to finance and reimbursement.Meets the required productivity and competency levels established for a full time Inpatient Coder
- (Inpatient:20 ) Meets productivity and competency standards for coding of Ambulatory Surgical records for a full time employee.(Outpatient:36) Codes pre-admission surgical testing forms on assigned day.Codes and enters discharges/re-admits at time of receipt from transferring unit.Completes DOH forms for appropriate records, i.e
- Spontaneous Termination of Pregnancy, Alzheimer's, Congenital Malformation, Induced Termination of Pregnancy, and Sterilization.Responsible for submitting DOH forms to the responsible person in a timely manner to ensure DOH Regulations are met
- Keeps a log of all forms sent.Assists in data audits as requested
- Responds to suggestions for change in timely manner.Assigns charts to appropriate review area for coding validation check.Responds to physician's coding questions when necessary.Performs related duties as required.*ADA Essential FunctionsPhysical Demands: Requires the ability to sit for long periods of time, high visual activity to review documents, high level of concentration without allowing distraction to impact workflow.
- High School Graduate or equivalent, required.Completion of one-year Coding Certification program or equivalent experience in coding, required.Credentialed CCS/RHIT, Required.One year of coding experience in an acute care setting with a complex case Mix and a skill level required to perform the job with accuracy.Requires excellent knowledge ICD-9 and CPT-4 coding principles.Requires good interpersonal skills in order to interact effectively with physicians and reviewers.Requires knowledge of medical terminology, anatomy and physiology.
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