Senior Hospital Coder

Department/Unit:

Health Information Services

Work Shift:

Day (United States of America)

Salary Range:

$60,367.47 - $90,551.20

The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding.

Essential Duties and Responsibilities

• Optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases.
• Understands the hospital inpatient/outpatient and CBO billing and registration systems.
• Assist with educating providers, clinicians, and others by advocating proper documentation practices and further specificity for both diagnoses and procedures when needed to more precisely reflect the acuity, severity, and the occurrence of events. Bring to the attention of the organization management any identified inappropriate coding practices that do not comply with requirements.
• Assist in problem solving processes and workgroups, including participating in the development of query policies that support documentation improvement and meet regulatory, legal, and ethical standards for coding and reporting.
• Assist leadership in team collaboration, leading meetings and onboarding new staff.
• Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities.
• Responsible for communicating both verbally and written to physicians, clinical departments, medical coders, and management teams.
• Query and/or consult as needed with the provider for clarification and additional documentation prior to final code assignment in accordance with acceptable healthcare industry practices.
• Provides feedback to coding staff on quality scores.
• Communicates with management when trends or concerns arise regarding poor quality.
• Schedules calls and is available for coding staff when they have questions related to coding.
• Leads a morning huddle one week each quarter in a 12-month calendar year.
• Communicates to Coding Support Specialist on topics for monthly meetings.
• Research new coding clinics, guidelines, and concepts and provides education to staff.
• Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements.
• Research coding forums and coding issues related to registration status.
• Works with a multitude of software systems at once, navigating efficiently between them. These systems include Meditech, Soarian Clinicals and Financials, 3M HDM and 360, Outlook, MS Teams, Word, Outlook, Excel, Glens Falls Hospital Citrix, Saratoga Hospital Citrix.
• Assists with organizing the shared drive for the medical coding department.
• Assist in development and compliance of comprehensive internal coding policies and procedures that are consistent with requirements.
• Actively participates in discussions and projects to improve turnaround time for coding.
• Participates in daily huddles and LEAN problem-solving activities.
• Demonstrates change-leadership skills. Supporting the collaboration of coders to improve inefficiencies and solve problems.
• Connect with coders when necessary. Being a mentor and guide to their success.

Qualifications

• High School Diploma/G.E.D. - required
• Associate's Degree In Health Information Management or related program - preferred
• Seven years’ experience in coding ICD-10-CM/PCS and CPT coding or five years’ experience with an HIM-related associate degree or higher.
• Experience with 3M 360 and EPIC - preferred
• Applicants must receive a minimum score of 85% on a coding assessment.
  (High proficiency)
• Expert level with reading a medical record to assign ICD-10-CM, ICD-10-PCS, and CPT4 codes, abstract data elements for billing and reporting, and assign DRG, APC, and APG as appropriate. (High proficiency)
• Highly skilled in team development, critical thinking, organization, verbal, and written communication. Skilled in team-o