Dignity Health Coder - Sr in RANCHO CORDOVA, California
Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.
The Coder reviews, analyzes, and approves codes for diagnostic and procedural information that determines Medicare, Medi-Cal and private insurance payments. The primary function of this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. The Coder shall review ICD-10-CM, CPT and HCPCS codes against documented information for DHMF clinical encounters. Assures the final diagnoses and operative procedures as stated by the physician are valid and complete. Reviews necessary information from health records to identify proper and congruent relationships between procedure and diagnosis codes utilizing EndCoder systems, LCD’s, NCD’s and modifier relationships.
The coder determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete. The coder shall open lines of communication with the health care professional and resolve discrepancies in coding practices and provide education as needed. Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code using both 1995 and 1997 CMS guidelines for auditing
Presents audit results to physicians for education and training purposes
Assists in the onboarding and training of coding employees
Assists in creating and updating training documentation in compliance with new regulatory information
Responsible for updating encounter forms annually in accordance with internal processes. Responsible for managing and identifying improvements in department workflow
Analyzes Claims Scrubber edits and researches discrepancies
At times will work in a lead capacity within the department.
Works on department projects as required
Responsible for internal reporting and distribution.
Works as an internal auditor within the department
Additional duties as assigned
High school diploma (or equivalent) required
Current CCS or CPC certification required
Enrollment in continuing education courses to maintain certification required
Five (5) years of coding and specialty experience required
Advanced knowledge of medical terminology, abbreviations, techniques and surgical procedures, anatomy and physiology
Advanced knowledge of medical codes involving selections of most accurate and description code using the ICD-10-CM, Volumes 1- 3, CPT, and HCPCS coding conventions
Advanced knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes
Effective communication skills
Ability to communicate effectively with all levels within the organization
Must be computer proficient
Working knowledge of Endcoder systems required
Intermediate level of Microsoft Office systems including Excel and Word required
Position requires schedule flexibility to work from DHMF clinics as business requires
Requires travel to meet with and educate providers in clinic locations
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If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this telephone number.
Job ID 2018-47365
Employment Type Full Time
Department Business Office - Coding / Data Entry
Hours / Pay Period 80
Facility Dignity Health Medical Group Region
Location RANCHO CORDOVA
Standard Hours Mon-Fri (8-5pm