HIM Coding Specialist

Job Summary

The HIM Coding Specialist performs coding and abstracting for inpatient and outpatient medical records accurately and timely to optimize reimbursement for all payer classes. Responsible for working billing edits in the EMR and claim scrubber. Normally scheduled Monday through Friday.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Supports and promotes an environment conducive with the Mission, Vision, and Values of the hospital.
• Analyses patients’ records for principle and secondary diagnosis, procedures and assigns the appropriate codes per established guidelines.
• Maintain current knowledge of HIPAA and best practices regarding medical records.
• Abstract any data required for the patients’ record.
• Ensures timely data entry of codes.
• Facilitates flow of medical record data to assure accurate and prompt reimbursement, data collection, and clinical data analysis.
• Interacts as a team member representing Health Information Management and attends meetings as directed.
• Reviews of all charges assigned to ensure accuracy and validity.
• Assign any addition charges needed for billing accuracy.
• Collaborates with physicians regarding diagnoses and procedures to ensure accuracy.
• Follow up with the provider on any documentation that is insufficient or unclear.
• Ensures that documentation is appropriate to meet medical necessity guidelines.
• Organizes and prioritizes assigned work and schedules time to accommodate work demands and turn-around time requirements.
• Ensures productivity and quality of coding the records.
• Recognizes, interprets, and evaluates inconsistencies and discrepancies in medical record documentation and reports them appropriately.
• Communicate with other clinical team members regarding documentation.
• Uses reference materials (coding books and 3M encoder) appropriately and efficiently.
• Is knowledgeable of general hospital and department specific policies and procedures including release of information, amendment of medical records and other legal requirements.
• Other duties may be assigned and are subject to change with or without prior notice.
• Assists in orienting and training new staff to department.

Professional Requirements

• Completes and maintains all required education and/or training requirements.
• Complies with HIPAA regulations and always maintains patient confidentiality.
• Follows and maintains all lawful safety, health requirements, and regulations, and follow protocols for required protective equipment (PPE).
• Promptly reports safety issues, job-related injury, or illness, near misses, etc. in SafetyZone.
• Follows Hillsboro Health Standards of Behavior.

Requirements

Education and/or Experience

High school diploma or equivalency with college courses in medical terminology, anatomy, and coding

Minimum 1 year experience in Medical Coding field, knowledge of reimbursement systems and Medicare regulations

Excellent customer services skills

Certificates and Licenses

• Coding Certification through AAPC or AHIMA

Physical Demands

Physical demands of the position, including vision, hearing, repetitive motion, and environment are required. A separate document will be provided upon hire, during annual evaluation process, and upon request. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.

CORPORATE COMPLIANCE

Receives training and/or attends necessary meetings to meet the criteria as outlined in Hillsboro Health’s Corporate Compliance Plan and Code of Conduct. Understands the responsibilities related to compliance and knows whether to contact the Corporate Compliance Officer should there be any instance of question or concern regarding fraud and/or abuse.

SALARY

Certified: $22.45 - $28.07 per/hr

Non-Certified: $20.41 - $25.52 per/hr