CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
The Coder reviews, analyzes, and approves codes for diagnostic and procedural information that determines Medicare, Medi-Cal and private insurance payments. The primary function of this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Assures the final diagnoses and operative procedures as stated by the physician are valid and complete. Reviews necessary information from health records to identify proper and congruent relationships between procedure and diagnosis codes utilizing LCDs, NCDs and modifier relationships.
The coder determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete. The coder shall open lines of communication with the health care professional and resolve discrepancies in coding practices and provide education as needed. Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned. Presents audit results to physicians for education and training purposes. Analyzes Claims Scrubber edits and researches discrepancies. Additional duties as assigned
High school diploma (or equivalent) required
Current CCS or CPC certification is required
Enrollment in continuing education courses to maintain certification required
Two (2) years of coding experience required
Three (3) years coding experience preferred
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