Memorial Hospital of Lafayette County (MHLC) – Medical Coding Specialist

Job Title: Medical Coding Specialist
Reports to: MHLC Lead Coder/HIM Director
Supervisory Responsibilities: None

Position Qualifications – Educational Requirements:
• High school graduate or equivalent required.
• One or more of the following credentials preferred:
• Registered Health Information Administrator (RHIA)
• Registered Health Information Technician (RHIT)
• Certified Coding Associate (CCA)
• Certified Coding Specialist (CCS)
• Certified Coding Specialist- Physician Based Coding (CCS-P)
• Certified Procedural Coder (CPC)
• Certified Procedural Coder- Hospital (CPC- H)
• A minimum of three to four years coding experience.
• Knowledge of medical terminology, anatomy, physiology, clinical medicine, lCD-10-CM, ICD-10, and CPT-4.

Position Summary: The Medical Coding Specialist is responsible for coding inpatient and/or outpatient data in accordance to all rules and regulations. Is also responsible for analyzing clinical documentation for quality and completeness.

Essential Job Functions:
Coding/Charge Review and Correction
• Works Account, Charge Review, Claim Edit and Denial Work ques to verify that billed Hospital, Ancillary, Outpatient and Primary Care Clinic charges have been appropriately identified for each patient visit including Evaluation and Management (E/M) Level, applicable Current Procedural Terminology (CPT) codes, inpatient charges, ICD-10-CM Codes and modifiers as wells as diagnosis codes in accordance with established coding guidelines.
• Codes encounters in accordance with Memorial Hospital of Lafayette County’s quality and productivity standards.
• Monitors coding of encounters to ensure all encounters are coded in a timely manner and assures charges provide optimal payment to which the facility is legally entitled.
• Communicates with appropriate staff, including providers and Patient Financial services to resolve problems encountered when coding and encounter.
• Accurately abstracts, keys, or posts codes for facility billing and completion of data bases.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
• Queries physicians when code assignments are not straightforward or documentation in the medical record is inadequate, ambiguous or unclear for coding purposes.
• Uses knowledge and skills to teach, coach and/or mentor others in the coding process.
• Viewed by coworkers as a reliable resource person in the coding process.
• Resolves National Correction Coding Initiative (NCCI) edits appropriately along with all Coding Edits as according to current Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs) and CMS Articles.
• Researches coding issues using available resources such and the internet, 3M encoder, provided coding books. Reviews issues with Lead Coder/HIM Director and submits tickets to resolve if determined to be appropriate by Lead Coder/HIM Director.
• In conjunction with Patient Financial Services, processes denials relating to coding errors.
• Demonstrates and understand to the medico legal implications and responsibilities related to the coding of patient records to protect the patient and the business/institution.
• Researches and investigates difficult cases using internet and speaking with the providers/nursing staff.
• Seeks educational opportunities to expand knowledge to new departments.
• Strives to increase coding knowledge by attending seminars, take education courses, and maintaining coding certification.

Abstracting/Auditing
• Collects, verifies and abstracts defined data elements from patient medical records and enters into computer database.
• Assures encounters are complete and accurate; resolves discrepancies, follows up to ensure completion of missing information.
• Continuously evaluates the quality of physician documentation and completes monthly written audits assuring quality documentation and coding by MHLC providers. Communicates deficiencies to the Lead Coder and HIM Director on a weekly basis.
• Provides education to facility healthcare professionals in use of coding guidelines, practices and proper documentation techniques.
• Educates physicians regarding improvements in documentation to meet established requirements, coding/reimbursement and quality of care issues.

Customer Relations/Communications
• Maintains confidentiality, is courteous to all customers (Patients, families, and all other hospital staff) addresses and follows up on all customer concerns.
• Acts as a liaison for coding issues between departments.
• Collaborates and communicates with other areas of the department in matters of mutual concern.
• Assists in responding to walk in and phone requests for information when ROI staff is unavailable.
• Communicates effectively by seeking and giving feedback, articulating ideas, listening and sharing information with all stakeholders (intra- and inter-departmentally).
• Participates in a variety of communication medium to stay abreast of current issues within the department and hospital.

Teamwork
• Exhibits and approachable, interactive style in relationships. Communicated effectively by seeking and giving feedback, articulating ideas, listening and sharing information with all stakeholders (intra- and inter-departmentally)
• Participates in a variety of communication medium to stay abreast of current issues within the department and hospital.
• Seeks and encourages alternative views.
• Acts with integrity and honesty, being willing to trust others and able to engender trust.
• Trains personnel as assigned.
• Recognizes values and builds on differences and commonalities in people.

Miscellaneous
• Recognizes and reports problems, errors, discrepancies and unusual circumstances and/or information with possible risk factors to Lead Coder/HIM Director.
• Reports documentation that may be regarded as unprofessional, frivolous, insulting, inflammatory, or inappropriate to HIM Director.
• Operates designated equipment as directed to complete assignments.
• Demonstrates proficiency in use of electronic health record software.
• Demonstrates effective, skillful, and efficient use of designated equipment, including software applications. Maintains equipment and work area, recognizes and reports needed repairs and replacements.
• Continues to explore additional ways to use the software available to improve job efficiency.
• Expands job-related knowledge and skills to improve performances and adjust to change.
• Attends in-services, participates in continuing education opportunities and reads articles and publications appropriate to job responsibilities and those required by MHLC and state regulations.
• Maintains and acceptable attendance records reporting to work, as scheduled, with minimal absences.
• Attends all mandatory meetings including RWHC Coding Roundtable Meetings.
• Completes mandatory in services within the specified time.
• Completes all other duties as assigned.

Typical Physical Demands:

• Standing, walking, and reaching outward some of the time
• Handling and audio acuity frequently
• Sitting and visual acuity very frequently
• Bending, climbing, crawling, squatting, and kneeling rarely
• Color vision required

Typical Mental Demands:
• Ability to deal with pressure to meet deadlines, to be accurate, to handle constantly changing situations, and to create a positive work environment
• Ability to deal with a variety of people, stressful situations, and handle conflict, while maintaining a positive work environment
• Ability to communicate in a professional manner both verbally and in writing
• Ability and willingness to gain new skills and knowledge necessary for the performance of essential job functions
• Ability to give receive and analyze information for the performance of essential job functions

Working Conditions:

• Frequent repetitive motions frequently
• Computer monitors very frequently
• Toxic chemicals, extreme temperatures, dust/fumes/gas, handling mechanical parts, electric shock potential, x-ray electromagnetic energy, high pitched noises, needles and other sharps, blood and other body fluids, communicable diseases and unprotected heights rarely

Employee Responsibility in an Emergency:
As an employee of Memorial Hospital of Lafayette County, you are expected to respond to emergencies involving the safety of patients, other employees, visitors and the facility. This includes the ability to assist with a possible evacuation of facility if that has been deemed necessary.

Management Statement:
This job description is not intended to be all inclusive. The employee will also perform other reasonable job related duties as assigned by the supervisor and/or other management personnel. Management reserves the right to change job responsibilities, duties and hours as needs prevail. This document is for management communication only and not intended to imply a written or implied contract of employment.

https://www.lafayettecountywi.org/hr/job-opening/mhlc-full-time-medical-coding-specialist-0

Deadline Note: 11:59PM