HIM Coding Technician

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

PRIMARY JOB DUTIES AND RESPONSIBILITIES:

The following are representative of the duties that the HIM Coding Technician will perform:

• Employee will comply with all laws, rules, and regulations relating to the position.
• The employee has a duty to report any suspected violations of the law to his/her immediate supervisor, compliance officer, or CEO.
• Employee will follow the coding guidelines set by AHIMA (American Health Information Management Association,) NCCI (National Correct Coding Initiative) edits, CMS (Center for Medicare and Medicaid Services,) and the Standards of Coding Ethics. 
• Selects appropriate assignments for coding from assigned work queues. 
• Assigns codes to ancillary outpatient and recurring encounters by: 
• Selecting the accurate principal diagnosis and procedure code;  
• Sequencing codes to optimize reimbursement in conformance with policies; Coding only diagnoses and procedures which can be substantiated by documentation with the medical records
• Distinguishing cases which require additional information from physicians and contacting the physician for clarification using either direct contact or the physician query form. 
• Where defined in policy: Verifies charges entered for the encounter match the documentation contained within the record. 
• Writes the record to an appropriate queue when charges do not agree. 
• Correctly utilizes coding applications & systems to appropriately code and abstract all assigned encounters. 
• Analyzes APCs and Modifier assignment to ensure all data has been considered to ensure accurate and compliant coding and charging.
• HIM Coders shall use their skills, their knowledge of ICD and CPT rules, guidelines and requirements and any available resources to select appropriate diagnosis and procedural codes.
• HIM Coders shall not change codes or narrative of codes so that the meanings are misrepresented, nor should diagnosis or procedures be included or excluded because the payment may be affected. Statistical clinical data is an important result of coding and maintaining a quality database shall be a conscientious goal. 
• Physicians will be consulted for clarification when conflicting or ambiguous documentation is noted in the record. 
• The HIM Coder is a member of the healthcare team and, as such, shall assist physicians who are unfamiliar with ICD, CPT or DRG methodology. 
• The HIM Coder is expected to strive for optimal payment to which the facility is legally entitled and will not engage in unethical and illegal practices to maximize payments by means that contradict regulatory guidelines. 

• Reviews unbilled to assure records are all coded within department timeframes.
• Maintains patient, medical record, department, and employee confidentiality at all times.
• Consistently demonstrates a positive attitude and fosters teamwork by offering assistance to others as needed. 
• Effectively uses tools provided to monitor coding backlog and coding errors needing correction.
• Works with other departments to correct inaccurate clinical or demographic information regardless of the source of the information. 
• Reviews the APC grouper edit and assists in clearing the edits related to coding and compliance.
• Assists with the orientation and training of new employees. 
• Provides input to supervisor regarding coding policies and procedures. 
• Fulfills yearly continuing education requirements of the department and the hospital, to include safety and mandatory in-services. Responsible for maintaining credentials.
• Attends and participates in department or section meetings. 
• Contributes to the overall operation of the department by performing other duties, as assigned.

MINIMUM QUALIFICATIONS:

• High school graduate or GED. 
• Knowledge gained through formal education programs sufficient to accurately apply ICD and/or CPT codes. Ability to demonstrate an in-depth knowledge of medical terminology, anatomy and physiology, disease processes, clinical foundations and clinical data management. 
• One year of experience using ICD and CPT coding strongly preferred; knowledge of APC's, modifiers and other payment methodologies preferred. 
• Registration/Certification as a CCA, CPC-A, CCS, CCS-P, CPC, CPC-H, CPC-P or RHIT required. Equivalent combination of education and/or experience may be considered. 
• Excellent interpersonal skills and the ability to effectively communicate verbally and in writing providing excellent customer service. 
• Excellent organizational skills with the ability to multitask and handle multiple priorities/tasks simultaneously in a fast-paced environment. 
• Basic computer literacy and proficiency in Microsoft Windows. 
• Basic proficiency with MS Office (Outlook, Word, Excel) 
• Electronic Medical Record (EMR) experience preferred; Cerner strongly preferred. 

PHYSICAL REQUIREMENTS: 

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. 
• Primarily sedentary work with prolonged periods of sitting. 
• Ability to move throughout the location, approximately 1 – 2 miles/day. 
• Ability to move between locations as required. 
• Ability to exert up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. 
• Ability to perform repetitive movements. 
• Adequate manual dexterity, visual acuity and hearing to perform the essential functions of the job.