ESSENTIAL FUNCTIONS:
· Responsible for coding and abstracting patients’ records for professional billing.
· Reviews patient medical records retrospectively and concurrently for the coding and sequencing of diagnoses and procedures for reimbursement purposes.
· Interacts and assists with coding requests and questions from billers.
· Serves as a resource for difficult coding questions and assists with insurance denials for correction and re-filing.
· Makes process improvement recommendations to management as identified, specifically related to registration and charge posting.
· Performs in compliance with federal, state, insurance industry regulations.
· Follows established hospital policies concerning corporate compliance.
· Keeps abreast of insurance carrier rules and changes by participating in carrier specific and MCI education opportunities.
MARGINAL FUNCTIONS:
· Work includes cross coverage in other areas as team needs.
· Maintains supply inventory and stocks supplies in various work areas.
· Participates in Performance Improvement activities as appropriate.
· Maintains professional appearance of work area.
· Participates in staff development activities and orientation as requested.
· Other projects and assignments as required by supervisor.
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
· High school diploma or GED required.
· One to two years post high school education preferred.
· A minimum of two years current experience with ICDM 9, CPT coding, and health insurance provider rules and regulations required.
· Coding Certification required.
· Knowledge of anatomy and physiology and medical terminology required.
· Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.
· Knowledge of physician EM coding desired
· Working knowledge of computer information systems required.
· Demonstrates professional, appropriate, effective and tactful written, verbal, and nonverbal communication with patient, families, medical staff, colleagues, vendors, and other departments throughout the continuum of care to promote continuity of care and services and enhance department image.
· Must be a self-starter and able to work independently and make appropriate decisions within hospital and departmental guidelines with little assistance from Manager.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity 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, national origin, disability, status as a protected veteran, or any other status protected by law.