Division: Eskenazi Health Sub-Division: Hospital Req ID: 25287
Schedule: Full Time Shift: Days
Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus, including at a network of Eskenazi Health Center sites located throughout Indianapolis.
FLSA Status: Non-Exempt
Job Role Summary:
The Professional Coder provides timely and accurate clinical coding and abstraction of inpatient and outpatient services as appropriate to facilitate compliant and optimized reimbursement, research, and PI initiatives. The Professional Coder is responsible for the coding, abstraction, and charge entry (as applicable) of one or more of the following:
• Professional and facility services, which may include evaluation and management services, ancillary/diagnostic services, and behavioral health services.
Essential Functions and Responsibilities:
Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County; models Eskenazi Health's values
Coding and Abstracting:
Identifies and assigns the appropriate diagnosis, procedure, and evaluation and management (E&M) codes in accordance with coding guidelines and departmental standards; audits notes from providers to ensure the provider is coding in a compliant manner according to governmental rules and regulations; provides feedback to the provider if there are any questions or concerns; meets with providers face-to-face to review documentation and coding guidelines as necessary; maintains acceptable levels of performance related to productivity and quality standards
Charge Entry:
Captures charges accurately based on documentation, and integrates charges and codes appropriately; makes suggestions for additions to the fee schedules based upon recognition of new procedures and/or supplies
Problem Solving:
Utilizes available resources appropriately to maintain quality and consistency in coding, abstraction, and charge entry processes; follows a defined process to query the medical staff for completion and/or clarification of documentation necessary to ensure coding compliance and accuracy; brings any concerns/issues to management's attention with examples within the same date of discovery
Medical Necessity:
Recognizes cases that require specific medical necessity coverage diagnoses, and applies Local Coverage Determination (LCD) policies as necessary
Helps Accounts Receivable Specialists with questions and concerns to ensure claims are compliant and accurate for submission and payment
Assists with training of new team members
Software Applications:
Utilizes applicable software to retrieve documentation, abstract data/codes, and retrieve work lists
Job Requirements:
Requires a minimum of High School diploma and coding credential from AHIMA or AAPC
Requires a minimum of 3 years of coding experience in ICD-10, CM, CPT-4, and HCPCS coding classification systems, preferably in a physician and/or mental health physician office/hospital setting
Epic experience a plus
Dental, vision, and/or DME coding a plus
Knowledge, Skills & Abilities:
Local Coverage Determinations (LCDs), Correct Coding Initiative (CCI) edits, and the healthcare billing process
Diagnostic and therapeutic tests, surgical procedures, and medical record documentation standards and retrieval
E&M guidelines, documentation requirements, and assignment for hospital inpatient and outpatient professional services
Apply medical necessity coverage determinations as applicable, and seek coverage in the medical record documentation
General computer skills, and ability to learn new skills quickly
Computerized abstracting systems
Revenue cycle process
Experience with clinical documentation improvement programs
Experience in concurrent coding environment
Excellent and professional oral and written communication skills
Excellent and professional customer service and organizational skills
Ability to work as an effective team member
Recognizes opportunities for improvement and brings them to management's attention with suggestions
Sets and adjusts priorities to meet departmental goals
Works independently and exercises professional judgment to meet daily operational demands
Demonstrates team-oriented, professional conduct when resolving operational issues which cross operational units within Eskenazi Health
Accredited by The Joint Commission and named as one of Indiana's best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community.
As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.