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Coder 3

Overview
Performs coding at an advanced level utilizing ICD-10-CM and ICD-10-PCS Coding Classification systems. Utilizes an encoder and computer assisted coding software to achieve accuracy and thorough coding. Researches complex coding scenarios and queries physicians on documentation for clarification. Assists with training of new staff. Prepares knowledge based documents such as an internal coding guidelines to educate staff. Problem solves complicated IT issues and assists others in resolving problems. Is an SME in coding.
Experience: 4 to 6 year's experience required coding all types of hospital visits or admits with a high degree of skill and expertise. Is a subject matter expert when it comes to ICD-10-CM and ICD-10-PCS coding and associated coding guidelines.
Knowledge: Advanced knowledge of medical terminology, anatomy, physiology, and disease process. Knowledge of encoders, computer assisted coding, and coding guidelines
Responsibilities/Job Description
Assigns ICD-10-CM and ICD-10-PCS codes to all diagnoses, treatments, and procedures on complex hospital visits and/or admissions. Is able to problem solve complicated coding issues and prepares knowledge based documents to share among staff
Validates computer assisted coding (CAC) generated and suggested codes in conjunction with encoder.
Is proficient in using various coding software tools.
Is able to solve complicated software issues along with IT experts and assists others in resolution.
Utilizes technical coding principals and MS-DRG and/or APR-DRG reimbursement expertise to assign appropriate ICD-10-CM and ICD-10-PCS diagnoses/procedures.
Assigns present on admission (POA) value for inpatient diagnoses.
Identifies non-payment conditions (HAC) and ensures correct reporting.
Extracts required information from electronic medical records and enters into encoder and abstracting system.
If applicable, identifies chargeable items for emergency department visits (facility and professional fees) and enters into computer system.
Trains new coders and transfers knowledge to them effectively.
Is a subject matter expert under the realm of coding.
Follows-up on unabstracted and unbilled accounts to assure timely billing and reimbursement.
Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. Collaborates with CDI Specialists to maximize MSDRG coding.
May query physicians on documentation according to established procedures and guidelines.
Exceeds productivity and quality standards as established by coding managers.
Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
Actively participates in creating and implementing improvements.
Performs other responsibilities as needed/assigned.
Qualifications
Required:
4 to 6 year's experience required coding all types of hospital visits or admits with a high degree of skill and expertise.
Trade or Vocational Certification
Completion of an accredited coding certificate program or a Health Information Technician program.
Is a subject matter expert when it comes to ICD-10-CM and ICD-10-PCS coding and associated coding guidelines
Knowledge:
Advanced knowledge of medical terminology, anatomy, physiology, and disease process.
Knowledge of encoders, computer assisted coding, and coding guidelines.
Credential Comments: CCS required within one year of entering the position. Continuing education requirements must be met to retain credential.



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