NHRMC, established in 1967 in Wilmington, NC, is recognized as a preeminent healthcare organization focused on leading our community to outstanding health. We have an 855 bed network of hospitals and multi-specialty physician group practices with more than 200 physicians. With a network of primary, specialty, neighborhood clinics and regional medical centers; you will find our culture is the very definition of best in practice. Join us and find out how many ways NHRMC offers you the chance to focus on what really matters - our patients and community.
About the Job
Location: NHRMC PG Administration
Department: Coding Team
Full Time Equivalent: FTE: 1.000000
Work Type: 64 to 80 Hours Pay Period
Work Schedule: 8HR DAY - Most of shift btwn 7A-3P
Exempt from Overtime: Exempt: No
What You'll Do
Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payers and other regulatory agencies. Functions includes but are not limited to reviewing surgical operative reports and abstracting clinical diagnoses, procedure codes and other pertinent information in order to bill appropriately for services. Will ensure physicians are continually educated on correct coding techniques to maximize reimbursement.
1. Coding: With minimal supervision, review and code work queues as assigned by applying coding principles for correct coding including sequencing. Query providers for clarification of incomplete or ambiguous documentation as appropriate and monitor for timely responses. Provides provider education and regular feedback on ICD-10 and correct coding issues. Evaluates and identifies front-end and back-end error trends for training needs and brings them to the attention of the coding manager. Communicates and participates in departmental meetings and initiatives involving coding and the revenue cycle enhancement process. Demonstrates a comprehensive knowledge of all procedures concerning the sequencing of diagnoses, procedures such as but not limited to those outlined in ICD-9- CM, CPT, HCPCS and CMS guidelines. 2. Process: Maintain adequate knowledge of coding, compliance and reimbursement procedures through review of information provided by RCS, payer policy updates and coding manuals: Provides coding assistance through interpretation of guidelines and communication to practitioner. Must be accurate in coding of diagnostic and procedure services in accordance with national coding guidelines and appropriate information reimbursement requirements. Responsible for responding to coding, billing and collection inquiries. 3. Error Audit: Help transition from a back-end “rescue and recovery” coding culture to a front-end educator through monitoring errors, edits and denials and providing confident on-site education to busy clinicians. Ability to provide reporting and analysis regarding coding efforts and explain coding differences and missed opportunities. Ability to become competent domain experts in the EMR diagnosis and ordering fields. Collaborate with the physicians to create pertinent and useful drop-down lists to eliminate rarely used choices that hinder accurate coding.
Education: High School Diploma Required, Associates Degree Preferred
Experience: Minimum of four years healthcare experience with at least three years of professional coding experience. Two years of medical terminology experience and three years of customer service experience in a clinic setting.
Licensure/Certification/Registration: CPC, CCS-P, RHIA or RHIT, Certified Outpatient Coding (COC)
Additional Skills Required: Working knowledge of Current Procedure Technology (CPT), ICD-9 and HCPCS coding. Experience with EPIC Resolute Billing preferred. Ability to effectively communicate and work with patients, physicians, staff and administration. Outstanding interpersonal, written and verbal communication skills. Ability to work independently with minimal supervision. Self-audit of work and awareness of impact on revenue cycle is key. Must be professional in demeanor, dress and communication style with the ability to pass a mock feedback session with physicians. Must have the ability to demonstrate knowledge of and utilize, apply, interpret and train on current coding classifications systems and documentation guidelines. Working knowledge of Current Procedure Terminology (CPT), ICD-9, ICD-10 proficiency and HCPCS coding.
This position description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications which may be required of the employee assigned to the position. Depending on the location of the job, duties may vary. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind; my employment with the Company is at will.
- Member Top 100 Hospitals – In 2016 NHRMC was recognized as a Top 100 Hospital demonstrating significant investment and financial sustainability for the communities we serve.
- Newsweek's 2020 list of Best Maternity Care Hospitals - NHRMC Betty H. Cameron Women's & Children's Hospital was named as a Best Maternity Care Hospital by Newsweek.
- Forbes America’s Best Large Employers 2018 and 2019- Link
- Becker’s 150 Top Places to Work in Healthcare- Link
- Healthgrades Outstanding Patient Experience
Consider a career at NHRMC and become part of this award winning team!