HIM Coder - Professional Job at Southern Ohio Medical Center
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GENERAL SUMMARYWorks under the supervision of the HIM Manager/Operations & Auditing. The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria, charge for procedures and other billable services provided in the clinic/office setting. Must have an understanding of the basic ICD-10 diagnosis and procedure coding rules and guidelines.
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QUALIFICATIONS
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Education:
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High School Diploma or successful completion of an equivalent High School Exam Required
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Successful completion of medical terminology course required
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Successful completion of an anatomy and physiology course preferred
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Successful completion of a formal coding training program preferred
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Licensure:
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None
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Experience:
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Two years of coding and charging experience required
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HCC/Risk Adjusted Coding experience preferred
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Interpersonal Skills:
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Must be able to gather and exchange information with providers, nurses, and other hospital personnel as well as outside agencies (CMS).
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Essential Technical/Motor Skills:
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Above average computer skills with the ability to type in order to accurately input information into a computer.
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Essential Physical Requirements:
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Ability to sit and analyze data and data entry for long periods of time
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Essential Mental Requirements:
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Ability to understand written and verbal directions in order to analyze a patient's medical record
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Ability to concentrate and pay close attention to detail for an exceptional period of work time when reviewing and analyzing records.
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Essential Sensory Requirements:
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Ability to see, interpret and read medical information
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Exposure to Hazards:
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None
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Other:
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None
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JOB SPECIFIC DUTIES AND PERFORMANCE EXPECTATIONS
- Confirms, verifies and adds charges as necessary for reimbursable high dollar supplies and ensures that documentation supports the charges captured.
- Assigns and abstracts charges for outpatient records of all work types including, when applicable, procedures, injections, observation hours, OR levels and other charges based on documentation and in compliance with established rules and guidelines.
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Determines sequence of diagnoses according to set guidelines and determines E/M leveling criteria, procedures and other services provided in the professional office.
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Understands the human anatomy, physiology, pharmacology and medical terminology to assure coding and charging accuracy.
- Abstracts codes from outpatient orders and electronic records to HDM after confirming the validity of the code in the code finder.
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Assists with denial management of professional denial that are coding or charging related.
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Maintains productivity and quality standards as set per work type comparable to national averages and benchmarks.
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Maintains a passing score on the annual HIM coding competency test at 80% or higher.
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Assists in Meditech ambulatory registrations.
- Performs other duties as assigned.
The following is a summary of the major job duties of this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
Location: Southern Ohio Medical Center · Health Information Management
Schedule: Contingent, Days, 100% Remote
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