Certified Network Facility Lead Coder

Job description

St. Luke's is proud of the skills, experience and compassion of its employees.

The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

Assist the coding manager with all activities related to hospital coding including but not limited to the coding professionals for the assignment of appropriate diagnosis and procedure codes to individual patient medical records for data retrieval, analysis and claims processing.

Codes and abstracts all pertinent medical information according to guidelines.

Abstracts patient information into Network’s health information computer system.

Collaborates with multiple departments including Health Information Management and Finance to ensure appropriate flow of patient health information.

ESSENTIAL FUNCTIONS:

Assist the coding manager with hospital coding workflow, monitoring account and claim edit work queues and re-assigning coding professionals as needed, including contract coding professionals when utilized.

Provides clarification to coding professionals regarding AHA coding rules and application to ensure consistency within the department

Assists with research of diseases and new technologies for appropriate ICD-10-CM/PCS/ CPT-4/HCPCS II diagnosis and procedure code assignment.

Assists the Coding Manager in the development, implementation and maintenance of coding department policies and procedures.

Assist with training of new coding professionals, working with them to meet/exceed department coding accuracy and productivity standards.

Codes and abstracts information from medical records according to ICD-10-CM/PCS, UHDDS, HCPCS II, CPT and CMS guidelines.

Utilizes the 3M Encoder to verify and assign ICD-10-CM/PCS codes and MS-DRG assignment.

Queries physicians for clarity on coding assignment.

Maintains a 95% coding accuracy rate as measured through quality reviews.

Responsible for maintaining up-to-date knowledge of coding principles and guidelines.

Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association; American Academy of Professional Coders and monitors coding staff for violations and reports to the Network Manager when areas of concern are identified.

Concerns involving compliance issues are also forwarded to the Network Manager for further action.

Demonstrates/models the Network's core values and customer service behavior and

interactions with all customers (internal and external).

Maintains confidentiality of all materials handled within the Network/Entity as well as the proper release of information.

Complies with Network and departmental policies regarding issues of employee, patient and environmental safety and follows appropriate reporting requirements.

Demonstrates/models the Network’s Service Excellence Standards of Performance in interactions with all customers (internal and external).

Demonstrates Performance Improvement in the following areas as appropriate: Clinical Care/Outcomes, Customer/Service Improvement, Operational System/Process, and Safety.

Demonstrates financial responsibility and accountability through the effective and efficient use of resources in daily procedures, processes and practices.

Complies with Network and departmental policies regarding attendance and dress code.

OTHER FUNCTIONS:

Act as a coding resource to other network departments as needed.

Other related duties as assigned.

PHYSICIAL AND SENSORY REQUIREMENTS

PHYSICAL/SENSORY DEMANDS: Sitting for up to 7 hours per day, 3 hours at a time.

Repetitive arm/finger use retrieving/viewing computerized patient medical record and abstracting of patient information.

Extended periods of vision use for reviewing computerized patient records, abstracting of patient information, approximately 7 hours per day, 3 hours at a time.

Hearing as it relates to normal conversation.

Occasionally may be required to use upper extremities to lift up to 10 lbs.; stoop, bend, or reach to retrieve resource materials and/or paper records in accordance with department downtime policy; use of wheel cart to and from Medical Records Department.

POTENTIAL ON-THE-JOB RISKS: No identified risks.

SPECIFIC PROTECTIVE EQUIPMENT AVAILABLE: N/A

MOST COMPLEX DUTY: Ability to apply objective understanding of ICD-10-CM/PCS/CPT diagnosis and procedure coding conventions and MS-DRG guidelines.

Appropriately assign diagnosis and procedure codes for accurate reimbursement.

Understands EPIC hospital health information system.

SUPERVISION (Received and/or Given): Coding Manager

COMMUNICATIONS:  Communicates frequently in a tactful, respectful and diplomatic manner with internal and external customers.

Advises Network Coding Director of CDCI on issues requiring immediate attention.

ADDITIONAL REQUIREMENTS: Expected to maintain designated CEUs for AHIMA/AAPC credentials (RHIA, RHIT, CCS, CPC, COC) in accordance with the AHIMA Governing Body and AAPC with confirmation of valid credentials for every two-year cycle reporting.

Adherence to the confidentiality guidelines as outlined within the Hospital and departmental policies.

Promotes positive customer satisfaction by way of prompt and courteous customer service.

QUALIFICATIONS

(MINIMUM)

EDUCATION:

Formal HIM education with national certification RHIA, RHIT, CCS, CPC, COC coding certification required.

Candidates with 5 years experience.

TRAINING AND EXPERIENCE:

Minimum 5 years coding experience in acute care setting and/or professional fee hospital coding required, teaching hospital setting preferred.

Past auditing experience or strong training background in coding and reimbursement preferred.

Previous experience with EPIC health information system and 3M encoding system preferred.

Leadership role preferred.

Please complete your application using your full legal name and current home address.

Be sure to include employment history for the past seven (7) years, including your present employer.

Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.

It is highly recommended that you create a profile at the conclusion of submitting your first application.

Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.

Required Skill Profession

Financial Clerks