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 Business Center A
Department: Coding and Revenue Integrity
Full Time Equivalent: full-time
Work Type: 64 to 80 Hours Pay Period
Work Schedule: STD HRS - Standard-Exe or Office w flex
Exempt from Overtime: Exempt: No
What You'll Do
Under the general direction of the Coding and Clinical Abstracting Manager, this specialist is responsible for accurate coding of diagnosis and procedures and DRG assignment for all inpatient records, He/She assigns codes from appropriate documentation in the medical record of the patient using appropriate code set classification systems including ICD-9-CM/PCS, ICD-10-CM/PCS, and CPT. The Coding Specialist IV communicates with physicians and professional staff including nursing and clinical documentation specialists to obtain clarification so that the medical record portrays an accurate clinical picture of the care delivered and supports compliant code assignment and reimbursement. This professional is skilled in writing compliant post discharge queries when needed to clarify documentation in accordance with facility guidelines. He/She is responsible for monitoring the Discharges Not Final Billed (DNFB) list, CFB days, and Case Mix Index, and plays an active role in meeting the organization’s revenue cycle goals. This specialist possesses an in-depth understanding of clinical indicators, disease processes, DRG reimbursement, Hospital Acquired conditions, PSI's, and CC/MCC payment impacts. This individual requires little supervision and performs all work independently, with a high degree of autonomy. All work is carried out in accordance with the department’s approved policies and procedures and in compliance with coding guidelines and standards of ethical coding.
1. Accurately codes all diagnoses and procedures and assigns the appropriate DRG for all inpatient encounters according to the appropriate classification system and in accordance with provisions of the Uniform Hospital Discharge Data Set as well as coding guidelines and all governmental and private Third Party rules and regulations.
2. Abstracts patient information from records of all assigned accounts and enters appropriate data elements into the computerized abstracting system.
3. Works with Coding Auditors, Clinical Documentation Specialists, and clinicians to identify areas for improvement in documentation and collaborates on educational initiatives regarding documentation and DRG assignment.
4. Consistently meets coding productivity target (100%) and accuracy requirements (95% or higher).
5. Communicates with physicians and professional staff including nursing and CDI specialists to obtain clarification, including writing compliant post discharge queries, so that the medical record portrays an accurate clinical picture of the care delivered and supports compliant code assignment and reimbursement.
6. Prepares workload reports and plays an active role in meeting the departmental and organizational revenue cycle goals.
7. Promotes customer satisfaction through prompt and courteous service.
8. Fosters respect for patient privacy by maintaining confidentiality in all phases of work.
9. Completes continuing education required to maintain credential.
10. Performs those duties necessary to ensure all accounts are processed accurately and timely.
* High School Diploma
Experience: Three-Five years in coding/abstracting using ICD-9-CM/PCS, ICD-10-CM/PCS and CPT-4 in an acute care hospital based setting required. Inpatient coding and DRG assignment experience preferred. Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
Performs other duties as assigned.
Individual will possess commensurate combination of education, experience and qualifications.
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.
Consider a career at NHRMC and become part of this award winning team!