To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Under General Supervision, Applies The Appropriate Diagnostic/Procedure Codes And Modifiers To Individual Patient Health Information For Data Retrieval, Analysis And Claims Processing. Performs Daily Reconciliation Of Charges For Accuracy And Completeness.
EEO/AA/Disability/Veteran
Responsibilities
- 1. Applies Appropriate Icd-9-Cm And/Or Hcpcs Codes In Accordance With Coding And Reimbursement Guidelines. Abstracts Pertinent Information From Patient Records.
- 2. Reconciles E/M Facility And Chemotherapy Charges And Codes With Physician Orders, And Nursing Administration Documentation When Required, And Pharmacy Dispensing To Ensure That All Drugs And Medical Services Are Appropriately Charged And Coded.
- 3. Queries Physicians And/Or Clinical Staff When Code Assignments Are Not Clear Or Documentation In The Record Is Inadequate, Ambiguous, Or Unclear For Coding Purposes.
- 4. Maintains Up-To-Date Knowledge Of Nccn Guidelines For Chemotherapy Drugs As Well As Anti-Emetic Drugs To Ensure Proper Diagnoses Are Billed Along With Any Additional Data Needed To Cleanly Process The Claim.
- 5. Keeps Abreast Of Coding Guidelines, Reimbursement Reporting Requirements, Pre-Auth Requirements, And Coverage Policies For Chemotherapy Drugs And Ancillary Services. Brings Identified Concerns To The Coding Manager Or Department Director For Resolution.
- 6. Safeguards Privacy Of Medical Information. Does Not Discuss Medical Information Contained In The Record With Unauthorized Personnel.
- 7. Meets Or Exceeds Performance Expectations For Coding Speed And Accuracy.
- 8. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
- 9. Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
Qualifications
EDUCATION
Work Requires Organizational, Analytical And Communication Skills Generally Acquired Through The Completion Of An Associate's Degree; Bachelor's Degree Preferred. Additional Years Of Experience Above The Minimum Requirements May Substitute For Educational Requirements On A One To One Basis (I.E. One Year Of Experience Equals One Year Of Education).
EXPERIENCE
Two (2) Years Of Hands-On Relevant Inpatient And/Or Outpatient Medical Coding Methodology Experience Required And/Or Quality And Proficiency Demonstrated As An Apprentice Coder At L+M; Cancer Center Related Billing/Coding Experience Preferred. Knowledge Of Medical Billing And Collection Practices, Third Party Reimbursement Methodology With Emphasis On Governmental Payors, Strong Analytical Skills And Excellent Oral, Written, And Customer Service Communication Skills Are Required.
LICENSURE
Coding Certification Required (Ccs Or Cpc Or Cpc-H)
SPECIAL SKILLS
Ability To Work Collaboratively, Independently, And Effectively Under Pressure And To Aggressive Deadlines.
YNHHS Requisition ID
107490