HIM GBR Coder . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The GBR Coder under general supervision is responsible for reviewing and if necessary, correcting codes that have been assigned by physicians and the Professional Service Coders to ensure they have been completed in accordance with the rules, regulations, and coding conventions of ICD-9-CM Official Guidelines for Coding and Reporting, Coding Clinic published by the American Hospital Association, the ICD-9-CM, CPT and HCPCS Code Book, CPT Assistant, NCCI Edits, and our client's organizational and institutional coding guidelines. The GBR Coder assigns and corrects codes for professional services rendered in the following settings: Inpatient Hospital (IP), Emergency Department (ED), Hospital Observation (HOPS), Hospital Ambulatory (HAS), Hospital Outpatient (HOV) and Medical Offices. Major Responsibilities: Review medical records and code assignment and if necessary, correct codes that have been assigned by physicians and PSC to ensure data and codes are consistent with ICD-9-CM Official Guidelines, CPT, CPT Assistant, CMS, MediCal, and USDOL as well as our client's Regional and Local Policies Demonstrate an in-depth expert level of knowledge of guidelines concerning the coding and sequencing of diagnoses and procedures such as, but not limited to those outlined in ICD-9-CM, CPT, UHDDS, CMS, MediCal, and USDOL Verify and abstract all medical data from the record to assign appropriate codes for the following settings: Hospital Emergency (ED), Hospital Observation (HOPS), Hospital Ambulatory (HAS), Hospital Outpatient (HOV) and Medial Offices Review Medical Records to resolve Ingenix and HealthConnect Coding Edits 65% Provides feedback to PSC Supervisors and Clinicians regarding corrections necessary to achieve the appropriate coding Document coding changes in the GBR Database daily which will contribute to monthly Feedback Report 20% Work Organization and Prioritization: under limited supervision organize and prioritize The successful applicant will possess the following requirements (items are required unless noted otherwise): At least three years of experience in professional production coding; billing and reimbursement; and/or related education Experience in a clinic setting of Coding specialization Extensive knowledge of medical terminology, medical coding (CPT-4 and ICD-9-CM) and state, federal, and Medicare Regulations Strong written and verbal communication skills with emphasis on relationship building and communicating effectively with a group Understanding of coding requirements for Lab / Radiology Services commonly performed in a medical center environment Pass an internal proficiency assessment for professional coding with a score of 80% or higher Be able to work independently and meet deadlines Accept roles with increasing responsibility Basic knowledge of our client's Revenue Cycle for the purpose of communicating corrective action recommendations will be a plus Working knowledge of Microsoft Office (Word, Excel, Access, and PowerPoint) Must be able to work in a Labor / Management Partnership environment Preferences: An Associate's degree in Healthcare Administration or Business Administration Completion of an approved AHIMA / AAPC Coding Course Experience in a managed care environment
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