ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Coding: Reviews medical records for the determination of accurate code assignment of all documented diagnoses and procedures in accordance with Official Coding Guidelines. Adheres to Standards of Ethical Coding (AHIMA).
- Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition.
- Coding Quality: Demonstrates consistency in achieving or exceeding 95.5% coding accuracy in the selection of principal and secondary diagnoses (including DRG, MCC & CC, SOI/ROM) and procedures. Demonstrates accuracy and consistency in abstracting elements defined by per facility.
- Coder Productivity: Meets and/or exceeds Conifer’s inpatient coding productivity guidelines
- Physician Queries: Demonstrates strong skills in creating appropriate and compliant physician retrospective coding queries.
- Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and ICD-10-PCS coding. Completes mandatory coding education as assigned. Quarterly review of AHA Coding Clinic. Attends all required coding operations conference calls.
- DNFB: Reviews held accounts daily for resolution in support of coding DNFB performance. Communicates barriers to leaders (physician queries, missing documentation, second level review, DRG reconciliation, etc.) for appropriate follow-up and resolution. Provides operational performance reports to leadership as requested.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Strong knowledge of MS-DRG and APR DRG classification and reimbursement structures
- Proficient at writing AHIMA compliant physician queries
- Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager
- Proficient in researching and responding to Business Office questions related to coding and/or payer-specific coding guidelines.
- Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency
- Works collaboratively with CDI, Quality and other facility leadership
- Functional knowledge of facility EMR, encoder, CDI tool and other support software
Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
- One to three years experience performing inpatient coding in acute care setting required
- High school graduate or equivalent is required
- Associate or Bachelor’s Degree in Health Information, Nursing, or other related field preferred. Years of coding experience would be considered in lieu of educational requirements.
