Job Description

Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 43 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 76 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Summary:  Reviews and assures that all services documented in the patient’s charts are coded with appropriate CPT, HCPCS and ICD codes. 

*Specialty: ENT

Essential Duties and Responsibilities include the following.  Other duties may be assigned. 

Evaluates medical record documentation to ensure appropriate assignment and sequencing of the correct diagnostic and procedure codes for services and treatments as documented in health records.Provides training, mentoring and direction to medical coding staff in the department.Works with clinics to resolve denials from the clinic denial logs.Requests additional medical records as needed to clarify missing or inadequate medical record information required to complete the coding assessment and adhere to documentation and billing requirements.Makes corrections as needed to ensure accurate coding and billing and reimbursement processing.Communicates coding results to the appropriate staff for data entry.Maintains a working knowledge of CPT, HCPCS and ICD coding principles, governmental regulations, protocols and third party requirements regarding billing and documentation.Remains current on all changes in legislative regulations that impact coding.Reports noncompliance issues detected through auditing and monitoring to the department supervisor and the Senior Director of Physician Coding and Documentation.Ensures assigned projects are completed in a timely mannerMaintains strict confidentiality of provider information, patient data, financial and billing informationReports noncompliance issues detected through to the department Manager and Senior DirectorComplies with all policies and procedures of the Corporate Compliance ProgramAttends meetings as requested, which may necessitate working in the evening or very early morningAssists with special projects as assigned by the Senior Director of Physician Coding, Documentation and Compliance and supervisorWork with other staff members to inspire teamwork and promote cooperation.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Fluent in the English languagePossess a vast knowledge of CPT, ICD and HCPCS coding and reimbursement issues for physician offices and clinicsStrong knowledge of 1995 and 1997 Documentation guidelinesExcellent understanding and comprehension of medical terminologyMust have the ability to balance and juggle multiple tasks, projects and requestsMust be able to make sound decisions objectively and follow throughAbility to communicate effectively any issues or weaknesses with coding and documentation to the providersMust be detail oriented and analyticalAble to interact confidently with providers, staff, corporate CHS management and/or other CHS affiliated personnelNormal visual and auditory activity is requiredEmotional and mental stability required to deal with periods of high stressPossess clinical knowledge and ability to evaluate and summarize clinical records to support successful appeal

Reasoning Ability:

Proven analytical and organizational ability.Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Computer Skills:

To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet software and Database software; practice management software and electronic medical records software.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to sit for prolonged periods of time, work on keyboard and view monitor for majority of the work day.. 

Certificates and Licenses:

CPC or CCS-P

Supervisory Responsibilities:

N/A

Education/Experience:

High School Diploma and/or GED

Minimum of 5 years experience working with physician offices or clinics working with diagnostic and procedure coding and/or medical billing

Physical Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:

The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.The Employee is not substantially exposed to adverse environmental conditions and; therefore, job functions are typically performed under conditions such as those found within general office or administrative work.