Yale New Haven Health System

O/P SPECIALTY CODER

US-CT-New Haven
Job ID
62501
Department
HIM CODING
Category
ADMIN/CLERICAL
Position Type
Full Time Benefits Eligible
Scheduled Hours
40
Work Schedule
DAYS
Work Days
MONDAY THROUGH FRIDAY WITH WEEKEND COVERAGE
Work Hours
FLEXIBLE
Work Shift
FLEXIBLE
Requisition ID
2017-15884

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

Performs a variety of complex coding activities including but not limited to charging, analysis of specialty services and the ability to code all other case types for a Coder 1 and Coder 2 to ensure department revenue integrity is maintained and billing is compliant. This information acts as a mechanism for indexing medical information; which is used for research, utilization, appropriateness of care, compilation of statistics for hospital, regional and government, and accurate reimbursement. Evaluates and monitors claims for accuracy prior to claim submission to ensure that it is correct as well as compliant. Interacts with other departments to maintain accurate revenue integrity and compliance. Mentors beginner coders and cross-trains others. Acts as an expert specialty coding resource to other coders and other hospital departments when coding questions /issues arise.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. Analyzes and codes patient encounters in a timely and accurate manner to ensure quality data and timely billing.
    • 1.1 Completes assigned work ensuring department benchmarks are met or exceeded consistently in accordance with current industry standards and use of current technologies.
  • 2. Special Skills HCPCs / CPT
    • 2.1 Interacts with other departments (i.e. Charge Master and Pharmacy) to maintain accurate revenue integrity and compliance completing required documentation to monitor and track issues and corrections.
  • 3. Performs a variety of departmental administrative tasks and coding related duties to assure the efficient operation of the department.
    • 3.1 Maintains Coding Certification (i.e. CCS/CPC/ COC/CIRCC) yearly by complying with requirements set forth by AHIMA and/or AAPC.
  • 4. Maintains professional skills and remains engaged in the goals and vision of the organization to ensure the department functions efficiently and accurately with integrity.
    • 4.1 Actively participates in staff meetings and offers constructive suggestions for improving the process.

Qualifications

EDUCATION


High School Diploma required. Associate's degree preferred. Certified Coding Specialist (CCS), Certified Coding Specialist Physician based (CCS-P) certification through the American Health Information Management Association (AHIMA) and/or Certified Professional Coder (CPC) and/or Certified Outpatient Coder (COC) through American Academy of Professional Coders (AAPC) is required. CIRCC certification Preferred.


EXPERIENCE


With high school diploma - CPC, COC, or CCS with a minimum of six (6) years coding experience. With an Associate's degree - CPC, COC, CCS with four (4) years of coding experience. Coding and billing related claim edits experience required. Work includes coding complex Cardiac Catheterization/Interventional specialty outpatient accounts.


LICENSURE


Either CPC, COC, CCS required. CIRCC Preferred.


SPECIAL SKILLS


In-depth knowledge of medical terminology, anatomy, physiology, and disease process. Knowledge of coding, billing, and the revenue cycle. Demonstrated knowledge of medical terminology and organization of the medical record coding systems. Comprehensive understanding of ICD-10-CM classification systems, and Medicare/Medicaid Evaluation & Management (E&M), Outpatient Prospective Payment System (OPPS) and Ambulatory Payment Classification (APC's). Good oral and written communication skills. Experience with HCPCS coding and pharmaceutical drug types/pricing.


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