Coder (Certified) Cardiology Clinic FT

Under limited supervision, is responsible for accurately and efficiently assigning CPT, ICD-9, HCPCS codes and modifiers to the patient encounter form in a timely manner. This includes but is not limited to office visits, nursing home visits, as well as, inpatient, emergency room and outpatient hospital visits. Performs coding education to co-workers and physicians. Adheres to the principles of Service Excellence Guiding Behaviors and the philosophy and mission of Mercy in all aspects of job performance.

MERCY MEDICAL SERVICES

POSITION DESCRIPTION

Position Title: Coder (Certified)-Clinic

Job Code: 1211

Reports To: Office Manager-Clinic

Pay Grade: PG 16

Dept/Clinic: MMS

FLSA: Non-Exempt

Approved By: Human Resources

Date: May 2018

OSHA: 0 - No Risk

POSITION PURPOSE

Under limited supervision, is responsible for accurately and efficiently assigning CPT, ICD-9, HCPCS codes and modifiers to the patient encounter form in a timely manner.  This includes but is not limited to office visits, nursing home visits, as well as, inpatient, emergency room and outpatient hospital visits.  Performs coding education to co-workers and physicians.  Adheres to the principles of Service Excellence Guiding Behaviors and the philosophy and mission of Mercy in all aspects of job performance.

ESSENTIAL JOB FUNCTIONAL COMPETENCIES:

1.

Demonstrates the knowledge and skills necessary to provide service/care appropriate to the age of the patients served, in accordance with Mercy standards.

2.

Maintains current knowledge regarding changes to CPT, ICD-9, HCPCS codes and modifiers in terms of revisions to definitions and modifications of codes themselves.

3.

Maintains current knowledge of government-funded programs and other third-party payers in order to effectively and accurately capture revenue.

4.

Is responsible for accurately and efficiently assigning CPT, ICD-9, HCPCS codes and modifiers to the patient encounter form in a timely manner.  This includes but is not limited to office visits, nursing home visits, as well as, inpatient, emergency room and outpatient hospital visits.  Prepares encounter form batches for code-scan entry.

5.

Assigns CPT codes for minor surgical procedures based on provider documentation.  Assist nursing and technical staff in assigning CPT codes for laboratory, radiology and other medical services.  Coders may change E/M codes with provider authorization.  Coders may add CPT codes with validation and authorization from the provider in the medical record. 

6.

Assigns ICD-9 codes based on information provided on the encounter form.  Coders may link diagnoses codes to CPT codes only when easily inferred.  Coders may add diagnoses when documented in the medical record for the related date of service.

7.

Assigns HCPCS codes for pharmaceuticals and supplies based on information provided on the encounter form by the nursing and technical staff.

8.

Assists patient service representatives and patient account representatives with interpretation of coding issues as necessary to expedite billing, refiling and appeals to third-party carriers.

9.

Interacts with physicians to resolve coding and documentation issues.  Is responsible for provider coding education and serves as department lead for evaluation of the coding process. 

10.

Understands the Codescan process and report editing.  May be asked to perform Codescan scanning and editing duties.

11.

Establishes and meets productivity and quality standards for coders.  Works to improve on lag time, denials, missing tickets, RVUs, etc.

12.

Serves as a resource and responds to inquire from internal customers, third-party carriers and other external customers.

13.

Provides feedback of suggested enhancements for reimbursement to providers and staff members in a professional manner.

14.

Acts in a professional manner reflecting the mission, philosophy and values of the Mercy Community Health Care System.

15.

Recognizes and communicates issues/occurrences utilizing established lines of authority, and assists in identifying ways to resolve variances or unacceptable outcomes.

16.

Actively participates in department meetings, committees, conferences, and in-services.

17.

Knows, understands, incorporates, and demonstrates the Mercy and Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.

18.

Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Mercy and Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

19.

Maintains confidentiality of information pertaining to clients, physicians, employees, and Mercy business.

20.

Demonstrates general working knowledge of computers and department specific software (i.e. Healthstream, internet, etc.)

21.

Performs other duties and responsibilities as assigned.

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.

MISSION STATEMENT

We serve together in Mercy and Trinity Health, in the spirit of the Gospel, to heal body, mind and spirit, to improve the health of our communities and to steward the resources entrusted to us.

GUIDING BEHAVIORS 

The Guiding Behaviors are the behaviors necessary for all of us to achieve our Vision.  They are:

We support each other in serving our patients and communities. We communicate openly, honestly, respectfully and directly. We are fully present. We are all accountable. We trust and assume goodness in intentions. We are continuous learners.

COMMITMENT

Must be able to embrace and adhere to the Guiding Behaviors of the organization and support the Mission of Trinity Health. Must demonstrate good work habits such as time management, attendance, punctuality, team building and other behaviors aligned to the Guiding Behaviors of the organization.

MINIMUM QUALIFICATIONS

Has successfully completed two years of education to include courses in medical terminology, coding and other related areas or consider two (2) years of related experience for each one (1) year of formal education.  Successful completion of a Certification by the American Health Information Management Association (AHIMA) as a Certified Coding Specialist (CCS-P) OR American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC). Must be detail oriented with an ability to organize work responsibilities. Must have a general working knowledge of computers and department specific software (i.e. Healthstream, internet, etc.) Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Mercy and Trinity Health.

Mercy cultivates, upholds and supports a safe work environment.  Associates support patient and staff safety by demonstrating aptitude and maintaining organizational employment standards and requirements.  Associate job performance is continually appraised and formally evaluated during the course of employment with Mercy.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

Must successfully pass employment physical examination and must adhere to applicable organizational requirements on an annual basis for Employee Health Directives.  Must possess the ability to comply with Mercy and Trinity Health policies and procedures. This job is categorized as ""Light Work"".  Has the physical stamina to meet the requirements of this job.   Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently.  Involves sitting most of the time, but may involve walking or standing.  Must be able to handle stress effectively. Must understand and accept the possibility of exposure to environmental elements, internal and external, which may affect the work place, such as infectious disease, chemical and/or chemical fumes, dust, noise, physical injury from an out of control patient, and adverse effects of inclement weather which may occur.

These essential functions identify the major requirements of the job.  They are not an exhaustive list of all job requirements.  An employee may be called upon to perform physical actions not specifically identified in this job description.