Responsible for reviewing health information for a patient encounter and applying ICD-10-CM-PCS and/or ICD-10-CM and CPT/HCPCS codes in accordance with the diagnoses and treatments documented, as well as report any other pertinent information for reimbursement and research purposes.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
General Skill Requirements
In addition to the Essential Functions and Qualifications listed above, to perform the job successfully an individual must also possess the following General Skill Requirements.
Concentration – Maintains attention to detail over extended period of time; continually aware of variations in changing situations.
Education and/or Other Requirements
Environmental Factors
Occasional exposure to moderate environmental variations, above-normal noise levels, and/or unpleasant substances. Exposure to hazardous or potentially injurious elements or conditions is limited.
Physical Demands
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Mental Demands
Essential Functions and Job Duties
· Identifies and assigns appropriate codes for the purpose of reimbursement, research, and compliance in accordance with ICD-10 and CPT coding guidelines.
o Complies with all federal, local and other legal requirements as they relate to medical coding practices.
o Reviews all inpatient, ancillary, clinic, and series accounts and assigns and sequences all diagnoses and procedure codes to the highest level of specificity documented in the provider notes.
o Observes confidentiality and safeguards all patient related information.
· Communicates in a positive and professional manner with visitors, physicians, and hospital staff.
o Maintains an optimal working relationship with peers, other hospital departments, and physicians.
o Exhibits understanding of CARES and the hospital mission statement.
o Attends continuing education classes to maintain coding proficiency in ICD-10-CM-PCS and CPT/HCPCS, and other areas as deemed necessary by management.
· Perform other job-related duties as required.
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