HIM Coder

to professional growth and a culture that embraces our five core values of Quality. Innovation. Service. Integrity. Transparency. JOB SUMMARY Under the general supervision, but according to established procedures, codes and abstracts patients records in order to meet billing and data collection needs of the hospital.

Works closely with hospital staff with regards to coding and assignment of a DRG/APC. JOB QUALIFICATIONS High School Diploma required. Graduate of an approved Health Information Technology/Management program, Coding Certificate Program, or AHIMA Independent Study. Credentials of RHIA, RHIA eligible, RHIT, RHIT eligible, CCS, CSS-P, CPC, or CPC-H. Must be able to demonstrate

proficient coding inpatient/outpatient ability. Analytical ability necessary to interpret data contained in records and to assign appropriate codes. Good knowledge of medical terminology, anatomy, and the organization of medical records.

The visual acuity necessary to read and decipher handwriting. Good communication skills. 3 or more years inpatient, outpatient, or physician coding experience. Extensive knowledge of ICD-9-CM, CPT-4 coding systems, DRG/APC assignment, LMRP application required JOB DUTIES Demonstrates the WMH Customer Service VALUES, which are key in providing quality service to patients and customers. Monitors workflow through the areas of coding and abstracting. Assures

records are coded and abstracted in a timely manner and the proper DRG/APC has been assigned.

Monitors and ensures quality of work through the coding area. Assures that information submitted for billing is accurate. Assigns ICD-9-CM code numbers to each diagnosis and procedure documented in the patient’s inpatient/outpatient medical record. For those cases where the diagnosis is obscure, determines the most appropriate diagnosis after a thorough review of the medical record and/or calls the physician. Accurately abstracts information from the medical records into the computerized abstract according to established guidelines. Codes inpatient and/or outpatient medical records using ICD-9-CM and CPT-4 coding rules and guidelines.

Enters and validates charges for outpatient departments utilizing charge capture tools and validates diagnoses with the medical documentation provided. Compares charges on accounts with the procedures coded and identifies any discrepancies. If any are noted contacts department manager to validate change and coordinates with Charge Master Coordinator to rectify the account. Reviews and identifies ay Local Medical Review Policy (LMRP) issues with outpatient accounts and rectifies these issues. Reports outstanding issues and potential solutions to these coding challenges to the Coding Manager.

Acts as an educational resources for other coders, various hospital personnel and the medical staff by answering questions pertaining to coding and DRG/APC assignment. Identifies records that are problem diagnoses and forwards to the Department Manager. Works closely with Case Coordinators in the assignment of an appropriate DRG for inpatient accounts. Review DRG data information from Case Coordinators in MIDAS and identifies working DRG with additional needed elements to be acquired from attending/consulting physicians for inpatient accounts Completes timely and accurate daily productivity logs and submits them to the Manager.

Monitors medical appropriateness of care provided to patients and reports disputable findings to the Utilization Review Department for inpatient/same day surgery/observation accounts. Collects requested data for the Department of Quality Improvement and reports findings. Provides codes to Admitting, Patient Accounting, Outpatient Clinics and various hospital departments upon request. Provides inpatient/outpatient coding training to staff and medial record students. Performs related duties, such as answering the telephone, aiding physicians in the completion of their records, and so forth.

Display courteous and professional manner through interactions, appearance, attitude and written and oral communication with physician, coworkers, supervisor and the public. Maintains at least ten continuing education hours annually. West Suburban Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, interaction, national origin, disability status, genetics, protected veteran status, interactionual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.