Medical Coding - Baystate Health

Req#: R18635
Category(s): Information Technology/Health Information Management, Medical Coding
Full Time / Part Time: Full-Time
Shift: First

Summary: 

Responsible for managing the operations of all Outpatient coding services and coding compliance for the Health Information Management Department. Ensures timely/accurate/compliant code assignment for claim submission/data capture and reporting. Participates in coding audit activities (internal and external). Provides training and in-service education to staff. Collaborates with various hospital departments and providers to ensure that the objectives of the department are met.

 

Job Responsibilities: 

1) Oversees the day-to-day activities, such as staffing, workflow, work routine, and special projects, and makes the changes as necessary, Includes but not limited to Outpatient coding, Coding compliance focus areas.

2) Ensures the Coding Department provides timely and accurate administrative and clinical data to ensure optimum reimbursement via random review of coded records. Monitors unbilled account reports for outstanding services or un-coded discharges to reduce accounts receivable days for inpatient coding;

3) Ensures coders meet quality and productivity expectations while ensuring DFNB meets expectations.

4) Supports and participates in audits and appeals with the various insurance carriers, including RAC audits. Audits works closely with the Patient Accounts Department.

5) Manages Coding Staff, including interviewing, hiring, performance appraisals, and recommendations. Evaluates staff during the probationary period to determine if successful completion of the probationary period is appropriate.

6) Queries physicians when code assignments are not straightforward or record documentation is inadequate, ambiguous, or unclear for coding purposes.

7) Maintains knowledge of medical record functions in addition to expert coding knowledge, researches, and answers medical coding questions.

8) Participates in Hospital Committees (i.e., Revenue, RAC, DHQ, ICD-10)

9) Liaison for physician coding services and works closely with Physician Billing Office management team to support outpatient coding.

10) In partnership with appropriate personnel, recommends and implements standardized,organization-wide coding guidelines and documentation requirements; develops and implements training and educational programs for physicians and coders.

Other Required Education

RHIA/RHIT and/or CCS required

Required Work Experience: 

1) 3-5 years of hospital coding, including ICD-10-CM,PCS, CPT with supervisory skills and experience

Preferred Work Experience: 

1) AHIMA ICD-10 Train the Trainer Certification preferred

2) 3M and Cerner experience

Skills and Competencies: 

1) Principles and practices of hospital administration; principles and practices of leadership and

supervision; principles of work planning and organization.

 2) Advanced principles and practices of medical record keeping in EMR; advanced medical terminology, anatomy, and physiology, as well as the states, sequence, progression, and description of diseases

as they apply to medical record coding and abstraction.

3)  Advanced elements of ICD-10-CM, PCS, CPT, APC, APG

4) Appropriate methods for auditing and reviewing information for quality control purposes.

5) The operation of standard office equipment; standard business computer hardware and software coding manager must be an effective team leader, efficiently balancing multiple responsibilities.

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

Bachelor of Science (Required), Master of Arts

Certifications:

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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