Hospital Based Coder Interventional - REMOTE

Advocate Aurora Health | Remote
interventional remote interventional health icd-10-cm management radiology data procedures health information management information management electrophysiology interventional radiology
R38309


  • Responsible for the final coding of outpatient account types for diagnostic and interventional Cardiac Catheterizations, Electrophysiology, and Interventional Radiology. This position is responsible for accurately assigning and sequencing diagnosis codes using ICD-10-CM in accordance with advice from Coding Clinic and ICD-10-CM Official Coding Guidelines. This position is accountable for utilizing 3M coding products including encoder and groupers for Medicare reimbursement and other third party payors, and for internal Advocate business and quality purposes. This position is accountable for accurate abstracting of selected clinical and non-clinical information to create a comprehensive database of information for billing purposes, internal data management, and external reporting of data.
  • Responsible for assigning ICD-10-CM diagnosis codes and all relavent CPT codes primarily for, but not limited to: Diagnostic and Interventional Cardiology, Electrophysiology, & Interventional Radiology, including Transplant accounts, Research Protocols and all aspects involved in coding these very high level, complex procedures. Including not only the addition of CPT procedure codes, but the addition of Radiology Supervision & Interpretation codes, selective catheter placements, HCPCS codes, and T-codes for emerging technology of these complex observation and day surgery accounts.
  • Familiarity with research case protocols, rules governing IP only paid procedures involving complex cardiac, electrophysiology and interventional radiology. Coding diagnoses using International Classification of Diseases (ICD-10-CM) protocols and Current Procedural Terminology involving transplant, congenital heart defects, ventricular assist device, device implants, complex cardiac medical, and emerging technology procedures). Independently determines principle diagnosis and reason for admission on all cases. Follows the prescribed organization's coding guidelines, adhering to all department quality and productivity standards.
  • Follows up and obtains clarification on inaccurate documentation as appropriate. Work with Revenue Assurance, billing, and other internal departments to ensure accuracy and coding compliance is being maintained.
  • Codes diagnoses utilizing a computerized encoding software system and completes abstraction for clinical data and non-clinical data elements for community and academic hospital sites. This position is responsible for reviewing all documentation in the patient record for accurate and complete code assignment in accordance with the current International Classification of Disease, Clinical Modification (ICD-10-CM).
  • Maintains a productivity rate of 100% or more on a monthly basis and a quality rate of 95% or higher. Responsible for reviewing all documentation in the patient record to identify all relevant diagnoses and procedures for coding accuracy.
  • Codes diagnoses and procedures utilizing the 3M360 encoding system and has knowledge in EPIC Chart Production. Selects and assigns codes for the appropriate first listed and all additional diagnoses according to Outpatient Coding guidelines with the official ICD-10-CM coding and reporting guidelines.
  • Compiles data for Center for Medicare Services (CMS) reporting of clinical indicators.
  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
  • Assists in ensuring coding compliance with federal, state, and other regulatory agencies, research cases, government payors and other selected third-party payors. Locates and utilizes the necessary resources to solve coding questions as they arise during the performance of daily duties.
  • Attends educational seminars and in-services to satisfy continuing education requirements to maintain certification(s). Reviews periodicals and literature to remain abreast of changes that will affect coding and reimbursement methodologies. Achieves productivity expectations to support discharged not final billed (DNFB). Attends monthly coding meetings as required. Promotes patient safety by reporting of issues through established channels and participating in safety initiatives.Safeguards confidential and privileged patient information.


Licenses & Certifications


  • Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or
  • Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA).


Degrees


  • Associate's Degree in Health Information Management or related field.


Required Functional Experience


  • Typically requires 5 years of experience in Cardiac and Interventional coding, with knowledge of the vascular and cardiac systems, which is equal to the knowledge level of an inpatient coder.
  • Must have experience in an integrated acute care teaching facility for 5 years.


Knowledge, Skills & Abilities


  • Proficient in Microsoft Office, Word, Excel, and PowerPoint. Advanced knowledge and understanding of Cardiac and Vascular anatomy & physiology in addition to general anatomy & physiology, medical terminology, pathophysiology (disease process, surgical terminology and pharmacology) and is able to apply these sciences to accurately assign codes to cases. Demonstrates knowledge of National Council on Compensation Insurance, Inc (NCCI) edits, and local and national coverage decisions. Expert knowledge and experience in ICD-10-CM and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Payment Classifications (APC). Advanced knowledge of pharmacology indications for drug usage and related adverse reactions. Expert knowledge of coding workflow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems. Excellent communication and reading comprehension skills. Demonstrated analytical aptitude, with a high attention to detail and accuracy. Experienced with remote workforce operations required. Strong sense of ethics.


interventional Cardiac Catheterizations, Electrophysiology, and Interventional Radiology coding experience.

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