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Job Title:

Department:

Coding services assigns diagnosis and procedural codes to inpatient and outpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Health System. ICD-9-CM and ICD-10-CM/PCS diagnoses and procedure codes are applied to inpatients and CPT-4 procedure codes are applied to all outpatients treated within the OSU Health System that are not captured through the charge description master. Medical record abstract data is assigned based on information reviewed for accuracy in IHIS during the coding process. This position is responsible for training medical record coding specialists and coding some or all the following types of records: inpatient, emergency department, ambulatory surgery, Talbot, outpatient clinic, pain block and ancillary areas. The Lead Medical Records Coding Specialist will also participate in hospital’s trauma registry.

Position Summary

The position is responsible for training and supporting new medical record coding specialists. The Lead Coder’s responsibilities also include auditing the coding of records, assuring inpatient and outpatient coding policies and procedures reflect practice, ensuring the integrity of information in the electronic medical record, and monitoring completion of coding activities. This position also codes medical records and other documents at the conclusion of the patient’s visit. This requires selection of appropriate admitting diagnosis, principal and secondary diagnoses, principal procedure and secondary procedures; assigning accurate ICD-9, ICD-10 and/or CPT-4 codes; sequencing the diagnoses and procedures codes; and abstracting information including admission source, type, disposition, admitting, attending and procedure attending physicians. Codes are selected in the Encoder Software following review of information in the electronic medical record system, IHIS. Information abstracted and coded is interfaced to IHIS Resolute 

Minimum Education Required
2-Year College Degree in Health Information Management or equivalent combination of education and experience

Required Qualifications
Associate Degree in Health Information Management or other qualifying associate degree in health care or minimum two years of daily hospital coding production specific to the area of discipline (i.e. inpatient coding or outpatient coding). Accredited as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) by the American Health Information Management Association, or Certified Outpatient Coder (COC) by AAPC or CPC with CHONC. Minimum of two years academic medical coding experience. 4 years of relevant experience required. 6 or more years of relevant experience preferred.

FUNCTION: Health Information Management
SUB-FUNCTION: Inpatient Medical Coding
CAREER BAND: Individual Contributor - Technical
CAREER LEVEL: 4

Additional Information:

Location:

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