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: FTE: 1.000000
Work Type: 64 to 80 Hours Pay Period
Work Schedule: STD HRS - Standard-Exe or Office w flex
Exempt from Overtime: Exempt: No
Remote Work Locations: NC, SC, GA, FL, VA, DE, MI, NV, OK, MS, AL, LA, IN, WY
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 for all observation, and outpatient surgery records, working from the appropriate documentation in the medical record of the patient. Classification systems include ICD-9-CM, ICD-10-CM, and CPT-4. The Coding Specialist III works with physicians and professional staff to obtain any necessary clarification concerning diagnosis and procedures, writing queries, charge referrals and medical necessity referrals as needed and according to facility guidelines. The Coding Specialist III is responsible for verifying, correcting, and posting charges and/or modifiers for designated service areas including observation, outpatient surgery, cardiac catheterization, endoscopy, interventional radiology, and infusions. He/She is responsible for monitoring the Discharges Not Final Billed (DNFB) list and plays an active role in meeting the organization’s financial goals. Possesses an understanding of OPPS, and APC reimbursement and the application of Local and National Coverage Determinations (LCD/NCDs). This person 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. This position is an advanced level technical position within the Coding Department.
1.Codes all diagnoses, 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 Association 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.Verifies, corrects, and posts charge and/or modifiers for outpatient surgery, interventional radiology, cardiac catheterizations, observation hours, bedside procedures, injections and infusions, observation hours, and other designated service areas.
4.Consistently meets 100% productivity targets and quality requirements (95% or higher).
5.Completes continuing education required to maintain competency and credentials (as applicable) and to stay current with coding rules and guidelines.
6.Works with physicians and professional staff to obtain any necessary clarification concerning diagnosis and procedures, writing queries, charge referrals and medical necessity referrals as needed and according to facility guidelines.
7.Promotes customer satisfaction through prompt and courteous service.
8.Fosters respect for patient privacy by maintaining confidentiality in all phases of work.
9.Performs those duties necessary to ensure all accounts are processed accurately and timely.
* High School Diploma
Education: High school diploma required, B.S degree or AA degree in Health Information Management or Nursing preferred. Extensive knowledge of ICD-9-CM, ICD-10-CM and CPT coding required. Advanced medical terminology, clinical medical concepts, and human anatomy and physiology required. Education may be through formal programs of study or through sequenced in-service training.
Licensure / Certifications: AHIMA credentialed CCS, RHIT, RHIA or RN preferred.
Experience: Three or more years coding/abstracting using ICD-9-CM, ICD-10-CM and CPT-4 in an acute care 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.
- 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!