Coder II

at St. Mary's Health & Clearwater Valley Health in Orofino, Idaho, United States

Job Description

Under general supervision and according to established procedures, assigns codes to medical records. Codes patient medical record under ICD-10, CPT, HCPCS guidelines. Abstracts required data from documentation to support the coding. Enters ICD 10 and CPT codes in electronic medical record and finalizes accounts. Does all professional data entry. Research information on claims that are denied, rejected, etc. or encounters other issues.  

Essential Job Functions:

• Analyzes patient medical records and interprets documentation to identify all diagnosis and procedures. Assigns proper ICD 10, CPT and HCPCS codes.
• Applies sequencing guidelines to coded data according to official code rules.
• Data entry for the professional coding.
• Works with providers to clarify medical record documentation and identifies issues that may need to be clarified.
• Answers questions regarding coding guidelines and assists other departments with coding and billing questions. 
• Remains abreast of developments in medical records technology by attendance at webinars and educational programs.
• Meets minimum quality and productivity standards. Inpatient coders will send weekly productivity reports to supervisor.
• Acts as a resource for pre-authorization, patient registration, physician offices, and insurance companies calling with questions related to ICD or CPT codes.
• Review pertinent literature and keep up with current coding challenges.
• Maintains confidentiality of all hospital and patient information at all times. Follows HIPAA regulations and policies.
• Communicate with patients, physicians, families and co-workers in person or on the telephone.
• Provides professional customer service and responds in phone, personal or through electronic communication.
• Regular and predictable attendance is an essential job function. 

Minimum Qualifications:

• High school diploma or equivalent
• Coding certification: AAPC, RHIT, RHIA, CCS or CCS-P required.
• 3 years' experience required
• Demonstrated thorough knowledge of ICD coding conventions and CPT coding principles and meet the recommended AHIMA coding competencies.
• Thorough knowledge of ICD/DRG coding optimization, and CPT coding principles including APC payment methodologies for outpatient hospital services is preferred.

Full time, 40 hours per week, Joint position.