HIM Coder-CDI Specialist

Fort HealthCare is a patient-centered hospital and healthcare system serving individuals, businesses and families in Jefferson, Dane, and Walworth Counties, and we are seeking HIM Coder-CDI Specialist to join our Health Information Management Team.

Shift: 
Full-time
80 hours per bi-weekly pay period
Day Shift

One year on site training in Fort Atkinson, WI required. Requires coding credentials (AHIMA-CCA or AAPC-CPC) within one year of hire. Must live within an hour and a half of Fort Atkinson, WI.

Fort HealthCare is proud to be named a 14-time award winner of the Milwaukee Journal Sentinel Top Workplace award for Southeastern Wisconsin, a 5-time award winner of the USA Top Workplaces award, and a 2-time winner of their Top Workplaces Culture Excellence award for Purpose & Values.

In addition, Fort HealthCare is proud to be awarded the inaugural 2024 Wisconsin Hospital Association (WHA) Hospital Mentorship and Quality Champion Award. The Hospital Mentorship and Quality Champion award recognizes a hospital for demonstrating mentoring relationships and engagement through active participation, collaboration and the sharing of tools and resources with other hospitals.

Our Mission Statement is our daily guide to provide the best health care possible. We promote it widely for all we serve to read, understand and to help our public hold us accountable for the promises we make.

Our Mission Statement - Improve the Health and Well-being of Our Community.

Our Vision Statement provides each of us at Fort HealthCare with a goal. It is our motivation to improve constantly upon the level of care we provide, and the quality of services delivered.

Our Vision - Be the Healthiest Community in Wisconsin.

We offer competitive pay and benefits, education, and resources you need to perform your job and ample opportunities for professional growth.

Assigns appropriate diagnostic and procedure codes utilizing ICD and CPT coding systems to facilitate billing, reimbursement and data collection.

Responsibilities of this position include:

• Interprets medical record documentation to identify all diagnoses and procedures. Assesses the accuracy of medical record documentation to ensure that it supports all diagnoses and procedures to which codes are assigned; knowledge based DRG assignment; knowledge based Ambulatory Payment Classification (APC) assignment of outpatient records.       
• Queries conflicting, ambiguous or non-specific documentation by consulting the appropriate physician following FortHC HIM policies and procedures.  a) Clarify conflict ambiguousness or non-specific documentation by consulting the appropriate hospital staff. b) Communicate in a professional, tactful manner as coding questions arise.
• Applies Uniform Hospital Discharge Data Set definitions to select the principal diagnosis, principal procedure, complications and co-morbid conditions, other diagnoses and significant procedures that require coding.
• Applies NCCI edits, LDC, NDC’s  and modifiers as appropriate          
• Applies knowledge of current approved ICD, PCS, and/or CPT coding guidelines to assign codes and sequence the diagnoses and procedures correctly. Utilizes encoder when appropriate for accuracy and efficiency. Verifies the accuracy of abstract entries
• Triages any conflicting, ambiguous or non-specific coding concerns to the Coding Coordinator.
• Applies knowledge of coding, billing and reimbursement rule/regulations to ensure accurate coding and charging; including multiple clinical settings.
• Responsible for knowing and applying internal coding policy and procedures.   
• Timely follow-up on unbilled/denial account reports to expediate claims.
• If assigned, accurately abstracts and reports all cancer cases from FortHC to the State Cancer Reporting Registry in a timely manner.
• Ensures timeliness of coding through use of computer-generated reports. 
• Meets productivity and quality ratings for the position. Meets required turn around standards and AR goal as identified by FortHC policy.

Requirements for this position include:

• High school diploma or GED and formal coding training required
• Associates degree preferred
• Minimum 1 year coding experience with on the job training and certification preferred 
• 3 years coding experience with coding certification in lieu of degree preferred