Medical Coder

Union position.

Start Date: TBD, but as soon as possible upon hire.

35 hours/week, 8:30am - 4:00pm, Monday - Friday

Must have Medical Coding certificate and be ICD10 certified. See attached job description.

Some travel between Cranston and Zambarano Hospital but primarily located in Cranston. Expenses not reimbursed. Must use own vehicle and valid driver's license.

Facility does not have electronic medical records. Coders will be coding from paper.

In addition to standard submission requirements, please include: Proof of Certificate of CCS by AHIMA or CPC through AAPC, and valid Driver's License.

GENERAL STATEMENT OF DUTIES: Review and evaluate in-patient and out-patient medical healthrecords to extract pertinent diagnostic, procedural and demographic information; ensure proper assignmentand maximization of financial reimbursement through proper interpretation and application of HCFA, ICD-10IO-CM and CPT-4 rules and regulations, and the correct selection, sequencing and coding of diagnostic andprocedural information; accurately abstracts information; accurately abstracts information for inclusion infinancial, statistical and billing data bases; and to do related work as required.

ILLUSTRATIVE EXAMPLES OF WORK PERFORMED:

• To review, evaluate and correctly in-patient and out-patient medical records and extractpertinent diagnostic, procedural and demographic information.

• To maximize financial reimbursement through proper interpretation and application of HCFA, ICD-ØCM and CpT-4 rules and regulations.

• To maximize financial reimbursement through correct selection, sequencing and coding of diagnostic andprocedural information.

• To bring questionable or poorly documented cases to the attention of the physician of record, Medical

Records Director or Medical Director for discussion, clarification and resolution.

• To collaborate with and provide expert assistance to medical staff and medical records staff regardingcoding and other related issues.

• To work closely with billing unit staff to ensure appropriate internal control of data.

• To verify information on the PSI abstract form and review additional information recorded on the PSIabstract form.

• To utilize computer systems in determining health care coverage for each patient.

• To ensure that health care records are coded, abstracted and forwarded to the billing unit for billingpurposes.

• To be responsible for maintaining a weekly "status" log of all admissions, transfer and discharges sothat all records aw accounted for and completed.

• To recognize the highly confidential information in a medical health record and understand the need for,and importance of, maintaining strict confidentially of all patient and hospital information at all times.

• To assist supervisor and medical staff in other related work as requested.

KNOWLEDGES. SKILLS AND CAPABILITIES: An extensive working knowledge of medical terminology, anatomy, physiology and pathology as well as a knowledge of pharmacology, diagnostic testing and medical procedures sufficient to allow accurate interpretation of medical record content and determination of precise diagnoses and procedures; a complete working knowledge and understanding Of ICD-10-CM and CPT-4 classification systems and demonstrate proficiency in the application of coding rules and regulations; knowledge of Medicare, Medicaid and other third-party payors; regulations and policies regarding billing and reimbursement, the ability to apply such knowledge for extracting and assigning proper codes for billing purposes; ability to provide guidance, direction and assistance when needed to medical staff, medical records staff and billing unit staff; and related capacities and abilities.

EDUCATION AND EXPERIENCE:

Education: Such as may have been gained through graduation from a college of recognized standing with specialization in medical record science; or graduation from a school of nursing, and certification as an CCS by AHIMA or CPC through AAPC.

Experience: Such as may have gamed through employment as a Coding Abstractor or Coding

Specialist and working with the CPT-4 classification system in the reimbursement area in an approved public or private hospital.

• Or, any combination of education and experience that shall be substantially equivalent to the above education and experience.