Gritman Medical Center

Role Description - Complies with all policies and procedures that pertain to HIPAA including minimum necessary requirements for this position. Must maintain 100% patient confidentiality for e-PHI during the course of work functions. - Responds to inquiries from Business Office on patient claims resolution. - Assists coding team with inquiries from departments to achieve timely resolution. - Assists coding team to ensure coding accuracy, completeness, and adherence to established guidelines and standards. - Participates in meetings with Revenue Cycle Committee and coding team. - Abides by the Standards of Ethical Coding set forth by AHIMA and monitors coding staff for violations and reports as areas of concern are identified. - Assists HIM Director in maintaining compliance with applicable regulations (e.g., ICD-10, CPT, or internal standards). - Trains new staff and existing staff on coding standards, tools, and updates. - Maintains knowledge of current professional coding certification requirements and promotes recruitment and retention of certified staff in coding positions. - Develops reports and collects and prepares data for studies involving cases for clinical evaluation purposes, fiscal impact, and profitability. - Assists HIM Director with developing and implementing coding policies, procedures, and best practices. - Assists HIM Director with tracking key performance metrics such as accuracy rates, productivity, and turnaround times. - Keeps abreast of recent technology in coding software and other forms of automation and stays informed about transaction code sets, HIPAA requirements and other future issues impacting the coding function. - Demonstrates competency in the use of computer applications and grouper software, medical edits, and all coding software and hardware. - The supervisor should demonstrate initiative and discipline in time management and assignment completion. - The supervisor must be able to work in a virtual setting under minimal supervision. Qualifications - Required Education: Associate or bachelor’s Degree and accredited by AHIMA. - Required Licenses and/or Certifications: Certified Coding Specialist (CCS) and Certified Professional Coder (CPC) Certifications. - Required Work Experience: Five (5) years in relevant working field, with one (1) year of supervisory experience. - Required Knowledge, Skills, and Abilities: - Advanced knowledge of ICD-10-CM and CPT coding principles and rules. - Strong leadership and communication skills. - Problem solving. - Good knowledge of medical records systems. - Excellent computer applications knowledge including Microsoft Word and Excel. - Must be fluent in general information technologies. - Significant level of autonomy, must be self-directed. - Intermediate to advanced knowledge of disease pathophysiology and drug utilization. - Intermediate to advanced knowledge of MS-DRG and APR-DRG classification and reimbursement structures. - Advanced knowledge of APC, OCE, NCCI classification and reimbursement structures. - Excellent organizational skills for initiation and maintenance of efficient workflow. - Regular and reliable attendance and time reporting per Gritman Medical Center Telecommuting program requirements. - Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment. - Good visual acuity. - Ability to operate computer keyboard, mouse, and other peripherals as appropriate to accomplish coding. Preferred Qualifications - Prefer five (5) years' experience in a supervisory role in healthcare with extensive knowledge of ICD-10-CM, CPT, HCPCS, and documentation guidelines. - EPIC experience, including HB and PB billing.