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: Yes
What You'll Do
Works independently but reports to the Coding Manager. This specialist is responsible for auditing inpatient records for quality of coding, assisting the Lead Coder with education, training and auditing of new coders, contacting physicians, residents and other healthcare professionals to clarify difficult medical record documentation and completing statistical forms and tracking logs. The Auditor will also serve as backup for coding, billing and abstracting of outpatient, ED and ambulatory surgery/same day surgery records. This specialist will be responsible for remaining current on all ICD-9 and CPT Coding changes, as well as payer specific requirements and regulations.
1. Conducts ongoing Coding Quality and Compliance audits, compiles results, and reports findings to the Coding Manager.
2. Works with Lead Coder to develop educational sessions and materials for coders and documentation specialists based on the results of audits and denials.
3. Serves as first point of contact with Clinical Documentation Specialists, to resolve DRG mismatches, clarify coding rules and work collaboratively to enhance the documentation improvement initiatives of the organization.
4. Contacts physicians and other direct patient care professionals to clarify difficult medical record documentation to ensure accurate code assignment.
5. Ensures that post discharge queries are completed in the correct format and in compliance with national standards, and departmental policy.
6. Keeps abreast of all new coding rules and guidelines and conducts on-going educational programs under the direction of the Coding Manager.
7. Serves as a resource for information and clarification on accurate and ethical coding, querying, and documentation standards, guidelines, and regulatory requirements.
8. Codes all diagnosis, treatments, and procedures according to the appropriate classification system for that category of patient encounter, and in accordance with provisions of the Uniform Hospital Discharge Data Set as well as the interpretation of these provisions as issued by the American Hospital Association and American Health Information Management.
9. Abstracts patient information from records of all designated patient accounts as well as other designated patient types, and enters appropriate data elements into the computerized abstracting system.
10. Promotes public relations through prompt and courteous service.
11. Fosters respect for patient/staff privacy by maintaining confidentiality in all phases of work.
Cert Coding Specialist
High School Diploma
Experience: At least five years experience coding inpatient and outpatient records in a hospital-based setting required. 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!