Work Type: Active - Benefit Eligible and Accrues Time Off
Exempt: No

Work Schedule: Monday - Friday (Remote)

Shift Time: 8:00am - 4:30pm
Location: Ambulatory Central Business Office, US:FL: Lakeland

Summary:
Under the direction of the Ambulatory Coding Quality Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes, and modifiers to clinic encounters and hospital-based services for reimbursement and statistical purposes. Assures that the provider and clincial staff documentation in the medical record supports any information provided in the claims. Communicates with providers or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes.

Detailed responsibilities:

• People at The Heart of all we do
• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

• 
  Safety And Performance Improvement
• Behaves in a mindful manner focused on self, patient, visitor, and team safety.
• Demonstrates accountability and commitment to quality work.
• Participates actively in process improvement and adoption of standard work.

• 
  Standard Work Duties: LRHPG Coder II
• Reviews medical records to determine if diagnostic and procedure codes are acurately reflecting the provider documentation.
• Assigns and sequences diagnostic and procedural codes and modifiers using appropriate classification systems and official coding guidelines.
• Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM, CPT, and HCPCS codes and modifiers.
• Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines.
• Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames.
• Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
• Identifies and summarizes findings for internal and external parties to help providers improve their documentation and coding. Educates, trains, and provides assistance in a variety of ways to help providers and clinic staff close gaps in diagnoses and treatment opportunities.
• Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.
• Reviews appropriate work queues/reports daily to address coding reviews, edits and corrections.
• Assists healthcare providers and clinics in identifying and resolving issues related to incomplete or missing chart documentation, ambiguous or nonspecific documentation or codes that do not conform to regulatory guidelines.

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  Stewardship
• Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
• Knows and adheres to organizational and department policies and procedures.

Education:
Essential:

• High School or Equivalent

Preferred:

• Associate Degree

Education equivalent experience:
Preferred:

• Accredited HIM program

Certifications:

Essential:
CPC, CCS-P, or CCS

Experience:

Essential: 2-5 years in a professional/ambulatory coding setting or acute care hospital outpatient coding experience.