Job Overview:
This position abstracts provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers.
Job Requirements:
High School Degree or GED
CPC-A, CPC, CCS-P, CCA
ICD-10-CM and CPT Coding Guidelines
Medical terminology
Anatomy
Physiology
Experience Related Fields
Job Responsibilities: Assists with coding/billing questions from both internal and external customers. Which will include follow up on denials, research, review of charts for potential coding issues. Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary. Communicate with other clinical staff regarding documentation trends. Maintains a close working relationship with all departments and internal customers including leadership and consolidates effotrts to ensure appropriate and standardized coding procedures are followed. Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources. Maintains knowledge of current coding revisions and effectively communicates changes with provider. Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI.
Other job-related information:
Qualifications: Successful completion of a certification program from an accredited organization. Strong knowledge of anatomy, physiology, and medical terminology. Excellent typing and 10-key speed accuracy. Commitment to a high level of customer service. Superior mathmatical skills. Familarity with ICD-10 codes and procedures. Solid oral and written communication skills. Working knowledge of medical jargon and anatomy preferred. Able to work independently.
Working Conditions:
Climbing - Rarely
Concentrating - Consistently
Continuous Learning - Consistently
Hearing: Conversation - Consistently
Hearing: Other Sounds - Frequently
Interpersonal Communication - Consistently
Kneeling - Rarely
Lifting <10 Lbs - Rarely
Lifting 50+ Lbs - Rarely
Lifting 11-50 Lbs - Rarely
Pulling - Rarely
Pushing - Rarely
Reaching - Rarely
Reading - Consistently
Sitting - Consistently
Standing - Frequently
Stooping - Rarely
Talking - Frequently
Thinking/Reasoning - Consistently
Use of Hands - Occasionally
Color Vision - Rarely
Visual Acuity: Far - Frequently
Visual Acuity: Near - Frequently
Walking - Occasionally
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:
Serve: ALWAYS…
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS…
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS…
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone’s opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS…
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS…
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community |
