About this Professional Coder role at South Shore Health
If you are an existing employee of South Shore Health then please apply through the internal career site.
Requisition Number:
Facility:
LOC0014 - 549 Columbian Street549 Columbian Street Weymouth, MA 02190Department Name:
Status:
Budgeted Hours:
Shift:
This role reviews clinical documentation, assigns appropriate diagnoses and procedures, identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.
The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.
Compensation Pay Range:
$26.30 - $37.60
ESSENTIAL FUNCTIONS
1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material.
a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy.
b - Assigns diagnostic and procedural codes for physicians in the inpatient, outpatient, and observation setting.
2 - Identifies any and/or all complications or comorbidities.
a - Applies sequencing guidelines based on medical record information provided according to official coding rules
3 - Assesses the appropriateness of medical record documentation to ensure that it supports the procedure(s), diagnosis', as well as complications and/or comorbid conditions documented. Consults with the appropriate provider to clarify medical record information.
a - Identifies any documentation inadequacies with provider and clarifies medical record information with courtesy and tact.
b - Retrieves any and all records corresponding to surgical cases including laboratory/path reports to ensure accurate assignment of ICD-10-CM and CPT-4 codes.
c - Ensures accurate, correctly coded information is entered into Epic
4 - Answers provider/clinician questions regarding coding principles,
a - Assists with coding queries for claims appeals and resolution.
b - Refer ancillary department coding questions to Professional Coding Manager
5 - Remains abreast of developments in medical record technology by pursuing a program of professional growth and development, attending educational programs and meetings, reviewing pertinent literature and so forth.
a - Utilizes professional affiliations, etc., in order to maintain current in professional developments.
b - Attends all pertinent coding seminars and manager assigned training.
c - Utilize all available hospital-provided electronic resources
6 - Works collaboratively with appropriate team members to recommend strategies for process improvement
7 - Assists in responses to billing review requests
8 - Abides by Standards of Ethical Coding as set forth by American Health Information Management Association (AHIMA)
9 - Meets coding, quality and productivity standards.
10 - Performs all job functions in compliance with applicable federal, state and local laws as well as hospital policy and procedures
JOB REQUIREMENTS
Minimum Education - Preferred
Equivalent to an Associate's Degree in Medical Information Technology (with course work in medical terminology, anatomy, physiology, disease processes, ICD-10-CM coding required and prospective payment preferred).
Minimum Work Experience
Two to three (2-3) years in a surgical practice preferred.
Required Certifications
CPC - Certified Professional Coder OR
CCS-P Certified Coding Specialist- Physician Based
Required additional Knowledge and Abilities
Strong proficient computer and data entry skills to gather and interpret data.
Strong analytical skills to gather and interpret data.
7-3:30
Responsibilities if Required:
Education if Required:
License/Registration/Certification Requirements:
