As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Responsible for assigning diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM and ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
* Coding: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA).
Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition.
Coding Quality: Demonstrates ability to achieve 95% or higher accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by per facility.
* Coding Labor Productivity: Meets and/or exceeds Conifer's coding productivity guidelines.
* Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and ICD-10-PCS coding. Attends mandatory coding seminars on annual basis for inpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls
* Communicates and resolves coding issues (lacking documentation, physician queries, missing documentation, second level review, DRG reconciliation, etc.) for appropriate follow-up and resolution
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.
* Knowledge of MS-DRG and APR DRG classification and reimbursement structures
* Understanding of appropriate level of care orders
* Working knowledge of Value Based Purchasing (VBP)
* Proficient at writing AHIMA complaint physician queries
* Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager
* Proficient in researching and responding to Business Office questions and/or question by the payer
* Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency
* Works collaboratively with CDI, Quality and other facility leadership
* Functional knowledge of facility EMR, encoder, CDI tool and other support software
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
* One to three years' experience performing medical record coding in acute care setting required
* High school graduate or equivalent is required
* Associate or Bachelor's Degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed preferred. Years of coding experience would be considered in lieu of educational requirements.
CERTIFICATES, LICENSES, REGISTRATIONS
* Required: AHIMA or AAPC approved credential
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
* Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments if appropriate
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/Hospital Work Environment
* Works in a private office space in the coder's home per conifer Telecommuter Policy as defined in the Telecommuting Program Guide
* Must be able to travel nationally as needed, not to exceed 10%