Coder 2 - Clinic, Patient Financial Services

To review and audit Network Provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations.  

 

 

 

 

#CB

Job Title: Coder 2 - Clinic

Job Summary:

To review and audit Network Provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations.  

1. Quality and Performance Improvement
   1. Research, develops and implements standardized process for quality monitoring of inpatient and outpatient coding and abstracting. Conducts quality audits for coding according to pre-established criteria in coordination with the Coding and Reimbursement Specialist. Assists Management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implements innovative ideas and process changes.
   2. Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. Participates in educational programs, in-services, and training sessions in an effort to share his/her own expertise with others and further the quality of education and personal growth provided to new personnel, volunteers, and interning students.
2. Collaboration and Partnership
   1. Establishes and maintains interdepartmental relationships with Network providers to facilitate cooperation and compliance. Assists the Physician Network, Revenue Management Department and other financial departments in clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas, and opportunities of education and process improvement.
   2. Collaborates with Management to identify and coordinate educational needs based audit results and new technologies. Provide support to the Coding and Reimbursement Specialist of monthly statistics and educational programs to staff on a regular basis. Provides technical assistance to the Systems Specialist for authorized coding database retrieval and identification and resolution of software and system functionality.
3. Other Duties As Assigned
   1. Performs other duties as assigned or requested.

• Associates degree, Bachelor's degree, or coding certification (CCS or CPC) with 3 years' experience OR 5 years' experience in medical coding without degree or certification
• Thorough knowledge of medical terminology, managed care financial agreements; Thorough knowledge of CPT-4, HCPC, and ICD-9 codes

FMOL Health is a leading health care innovator in Louisiana and Mississippi. We bring together outstanding clinicians, the most advanced technology and leading research to ensure that our patients receive the highest quality and safest care possible.

This commitment is grounded in a history that is more than 100 years old, but reflected today by our strategic vision of transforming healthcare through superior performance and excellent patient care.
In the last fiscal year, FMOL Health had:

• 1,747 Licensed Beds
• 65,322 Discharges
• 44,592 OR Procedures
• 10,827 Full Time Employees
• 331,360 Inpatient Days
• 1,915 Active Medical Staff
• 229,296 Emergency Visits

As a nonprofit, mission-focused Catholic healthcare ministry, we give special attention to our citizens who are most in need. During the most recent fiscal year, we provided more than $39 million in unreimbursed care and community support to the underprivileged.

Our health system is one of the largest in Louisiana, with hospitals, clinics and physicians located throughout Louisiana and in Mississippi. In fact, we provide care to almost half of Louisiana’s citizens, and serve in Mississippi's largest metropolitan area. Because of our size and the partnerships we have with other local organizations, we are able to pool our resources and share cost and service efficiencies and learn from each other, thereby accelerating our ability to improve care and solve challenges.

Since our founding in Monroe, Louisiana in 1911, we have been blessed by the guidance of the Franciscan Sisters. Through their guidance and steadfast example, we have committed to assure that we perpetuate their healing ministry for another hundred years. It is a noble purpose we strive to fulfill every day.

Headquartered in Baton Rouge, Louisiana, we serve patients across Louisiana and Mississippi through a network of hospitals, clinics, physicians, elderly housing and integrated information system. Our health system has partnered with the State of Louisiana as it transforms its healthcare delivery system. The partnership includes in