• Lifespan Corporation
  • Providence , RI
  • Scientific Research
  • Full-Time
  • 25 Broadway

Summary:

Ensures accurate coding and

data quality creating consistency and efficiency in inpatient and/or

outpatient services through ongoing performance of ICD-10-CM and/or CPT coding

validation and accurate MS DRG APR DRG and/or outpatient APC.

Responsibilities:

Performs coding quality reviews on inpatient records to

validate the ICD-10-CM codes DRG group appropriateness missed secondary

diagnoses and procedures and ensures compliance with all DRG mandates and

reporting requirements. Ensures

validity of data prior submission of bill. Performs retrospective coding audits

as required.

Performs data quality reviews on outpatient encounters to

validate the ICD-10-CM CPT and HPCS Level II codes modifier assignments APC

group appropriateness missed secondary diagnosis and procedures and ensure

compliance with all outpatient coding mandates.

Ensures medical necessity criteria is met and local medical review

polices are followed.

Continuously evaluates the quality of the clinical

documentation to spot incomplete or inconsistent documentation for inpatient

encounters that impact code selection and resulting DRG groups and

payments. Brings identified concerns to

department manager for resolution.

Provides training for coding staff and educates facility

healthcare professionals in the use of coding guidelines and practices proper

documentation techniques medical terminology and disease processes as it

relates to the MS DRG APR DRG and/or outpatient APC and other clinical data

quality management. Maintains knowledge of current professional coding

certification requirements.

Reviews LifeChart coding validator coding error and CED

work queues. Identifies any coding or coding related charge issues to

leadership. Performs routine coding validation audits. Prepares reports for director on coder accuracy

results.

Abides by the Standards of Ethical Coding as set forth by

the American Health Information Management Association and monitors coding

staff for violations and reports to Coding Manager when areas of concern are

identified.

Provides direction to coding staff in absence of management.

Other information:

BASIC KNOWLEDGE:

Associate degree in health information technology

(preferably with RHIT) and/or successful completion of coding certification

program. Understanding of the content of

the medical record. Trained in medical

terminology medical science disease processes anatomy and physiology. Ability

to recognize and understand clinical documentation pertinent for coding. Good writing skills to prepare compliant

physician queries. Computer literate;

capable of researching websites to access regulatory requirements. Ability to navigate the patient electronic

medical record. Coding specialist

certification required.

EXPERIENCE:

Five years coding optimization experience in an acute care

facility. Past auditing experience or

strong training background in coding preferred.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

Normal office environment.

INDEPENDENT ACTION:

Performs independently within the department?s policies and

procedures. Refers specific complex

problems to the supervisor when clarification of the departmental policies and

procedures are required.

SUPERVISORY RESPONSIBILITY:

None.

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.

Location: Corporate Headquarters USA:RI:Providence

Work Type: Full Time

Shift: Shift 4

Union: Non-Union


Associated topics: aseptic, diet, drug development, health, immuno oncology, medicine, nephrology, nutritionist, patient, physiology

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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