JOB SUMMARY

Support and provide coding and compliance training to clinical personnel, billing, and/or other client staff. Establish effective communication with clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues. Participate in special audits and system administration as necessary.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Proficient in inpatient and/or outpatient diagnosis and procedure coding guidelines
• Proficient in CPT/HCPCS code assignment including Evaluation & Management facility coding guidelines
• Knowledge of MS-DRG, APR DRG and CPT classification and reimbursement structures
• Proficient at writing AHIMA complaint physician queries
• Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness
• Functional knowledge of facility EMR, encoder, CDI tool and other support software

EDUCATION / EXPERIENCE

• Required: Three (3) to five (5) years’ experience performing medical record coding in acute care setting
• Required: High school graduate or equivalent is required
• Preferred: Associate or Bachelor’s Degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Performs diagnosis data submissions to Client, Vendors and internal Stakeholders
• Develop monthly productivity and revenue projections
• Responsible for chart assignment oversight and monitoring accounts on hold
• Prepares data collection reports for leadership
• Monitors diagnosis submission progress; Audit diagnosis submission files to ensure accuracy
• Reviews, analyzes and oversight of prebill/post bill reviews and pending accounts
• Works to resolve workflow, systems and complex matters related to coding

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Proficient in inpatient and/or outpatient diagnosis and procedure coding guidelines
• Proficient in CPT/HCPCS code assignment including Evaluation & Management facility coding guidelines
• Knowledge of MS-DRG, APR DRG and CPT classification and reimbursement structures
• Proficient at writing AHIMA complaint physician queries
• Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness
• Functional knowledge of facility EMR, encoder, CDI tool and other support softwar

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to work in sitting position, use computer and answer telephone
• Must be able to lift up to 25lbs

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Office Work Environment
• Works in a private office space in the coder’s home per conifer Telecommuter Policy as defined in the Telecommuting Program Guid