The Christ Hospital Health Network Coder II - Medical Records in CINCINNATI, Ohio

Job Overview: Interpret clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. Ensure highest level of reimbursement practice efficiencies and compliance related to coding procedures.

This position may perform the following job duties:

  • Responsible for translating healthcare providersā€™ diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines.

  • Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance.

  • Utilize technical coding principals and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures including understanding all elements in E/M coding.

  • Regularly communicates with the healthcare provider to ensure documentation and coding accurately reflect care rendered in a timely manner.

  • Facilitates healthcare provider education in areas of CMS regulations, coding, billing, documentation and administrative guidelines.

  • Utilize thorough understanding of the facility and physician practice health record content to extract pertinent information required to support or provide specificity for accurate coding.

  • Code at a productivity and quality rate consistent with organizational standards.

  • Identify and research encounters with potential TCHHN inpatient related bills to ensure compatibility and compliance. Discuss discrepancies with facility coder to determine appropriate coding ā€“ using opportunities to teach and/or learn.

  • Analyze denial and rejection reports and appeals when necessary to ensure compliance with payor and/or regulatory requirements.

  • Provide feedback and impact to the Healthcare physician/provider and office manager regarding denial and rejection trends.

  • Monitor documentation and coding practices to identify and follow up on potential coding related compliance issues and/or missed revenue potential.

  • Maintain current knowledge base in all aspects of CPT, HCPCS and ICD-9-CM and ICD -10-CM coding.

  • Keep abreast of all current billing and coding rules and regulations affecting government and non-government payers, and disseminates information to appropriate individuals as needed. Reviews and researches coding/billing issues, including but not limited to, rejection reports and claim denials. Perform regular analysis of the impact of coding and clinical documentation on reimbursement and identifies trends and opportunities for improvements.

Education: Skills assessment required to determine competency level of coding skills. Associate degree in HIM with RHIT or Certified Coder Specialist-Physician (CCS-P) or Certified Professional Coder (CPC) required.

License & Certification: RHIT or Certified Coder Specialist-Physician (CCS-P) or Certified Professional Coder (CPC) required.

Experience: Combination of approved education and/or 3 years related experience.