Coder/Coding Auditor Coordinator

POSITION:                   Coder/Coding Auditor Coordinator

DEPARTMENT:         HIS

HOURS:                       Full-time/ Exempt

UNION:                       Non-union

Qualifications

Education/Training:  Accredited coding or Health Information Technology program.  Extensive coding experience can be in lieu of educational program.

Skill(s): 

  • Ability to maintain current working knowledge of ICD-10-CM, CPT, E/M and HCPCS coding guidelines for inpatients and outpatients.
  • Ability to maintain working knowledge of billing regulations.
  • Ability to communicate (written and verbally) with and educate providers and peers on coding guidelines.
  • Ability to gather/tabulate/summarize data and information.
  • Ability to respond to change productively and positively and to handle additional tasks/projects as assigned.
  • Ability to maintain and enforce confidentiality in all phases of work and to have knowledge of and follow HIPAA guidelines.

Experience:  Five years experience in ICD-10-CM (ICD-9-CM) CPT-4, E/M and HCPCs coding.

General Responsibilities

Under the general direction of the Health Information Manager, the coder/coding auditor is responsible for coding of inpatient and outpatient records (ICD-10, CPT-4, E/M and HCPCS), tabulations of statistical data, and participation in the quality management process including peer review.  The coder/coding auditor will also provide feedback and give education to providers and peers, as appropriate.  All work is carried out in accordance with the HIS department’s approved policies and procedures.

Essential Responsibilities:

  1. Maintain knowledge of CAH conditions of participation standards and other external agency rules and regulations that affect medical records.
  2. Assure that all standards and regulations are followed.
  3. Participates in performance improvement analysis and activities.
  4. Assist department heads in maintenance of quality assurance program through chart abstraction and statistical analysis.
  5. Assist as needed with education and with coding of patient charts following coding guidelines and billing regulations in order to maintain departmental coding accuracy ratio of 90% or greater.
  6. Assist with tracking of coder production and accuracy to be used in periodic and annual reviews.
  7. Assist with trouble shooting, and coding in order to maintain bills on hold days at less than 10 and days in account receivable at less than 65.
  8. Provide feedback and education to providers on coding guidelines/regulation.
  9. Provide feedback and education to peers on coding guidelines/regulation.
  10. Follow through and work with billing office staff on claims denied due to coding issues.
  11. Assure that data is gathered in the required format.
  12. Operate office equipment normally used in the routines of daily work.
  13. Assumes responsibility for own growth and development.
  14. Assesses personal and learning development needs.
  15. Attends meetings and workshops to enrich personal knowledge, growth, and skills.
  16. Equipment is operated in a safe and efficient manner.
  17. In collaboration with the HIS Director, assist in developing an annual budget for the department and oversee the operational implementation of the budget.
  18. Assists with coding staff recruitment, development, and retention. Assists in interviewing and hiring staff.  Completes and signs coding employee evaluation forms.  Assists with supervising and evaluating coding staff performance.  Assists with writing and administering annual performance appraisals on department staff.
  19. Assists with authorizing and administrating coaching/counseling and disciplinary to coding staff.  Provides guidance and constructive criticism as needed.  Renders discipline as dictated by CCMH’s policies i.e. progressive discipline: coaching-verbal warning-written warning-final written warning-suspension- termination.
  20. Represents CCMH management and responds to and adjusts grievances in the coding areas.
  21. Assists with validating time and attendance (time cards) and approves PTO/vacation requests.
  22. Assists with coordinating and assigning coding job duties, scheduled work hours and schedule changes and approves overtime.
  23. Assists with promoting coding staff within the departments and approves of interdepartmental and intradepartmental transfers.
  24. Supervises and evaluates work performance in accordance with job description of coding. personnel assigned.  Monitors staff competency and continuing education participation.
  25. Nominates department staff for the GEM award when they go above and beyond and recognizes and rewards staff whenever possible.
  26. Develops, implements, monitors and evaluates ongoing coding improvement programs.
  27. Performs other duties as assigned.