Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.
Works independently under the supervision of the HIS Coding Coordinator, utilizes critical thinking and applies disease process knowledge, NSH coding guidelines and acceptable audit principles to all coding audit activities. Monitors the Clintegrity 360 Compliance software system to ensure assigned audits are completed in an accurate and timely manner for coding quality and billing purposes. Assist the HIS Coding Coordinator to monitor and ensure suspense levels are maintained within acceptable turnaround time. Participates as assigned in the Clinical Documentation Improvement activities at NSH.
PRIMARY DUTIES AND RESPONSIBILITIES
- Audits outpatient accounts prior to final billing.
- Analyze all provider documentation and associated coding for accuracy of code assignment, disposition code, and abstracted data utilizing all available software resources.
- Make any changes to coding summary as needed and assist with tracking and reporting of change data.
- Completes account reviews as needed from Revenue Integrity, Patient Financial Services, Data Quality Integrity, etc.
- Communicates with HIS regarding insufficient documentation holding up accounts from coding/billing.
- Using established guidelines, determines if $0 balance accounts should be coded and codes the account accordingly.
- Works on resolving accounts assigned to the Work List on a daily basis or any issues that may fall under Pending.
- Integrates physician documentation, coding data, and coding guideline support to outpatient coding related denials, drafts response letters and collaborate with the Business Office to resolve.
- Must be able to meet AHIMA based productivity expectations.
- Collaborates with clinical departments and other internal hospital departments related to coding questions.
- Serves as liaison for various internal and external outpatient coding reviews.
- Participates in educational programs, weekly conference calls and in-service and other meetings as needed.
- Performs other related duties as identified.
- Coding Certification or Registered Health Information Professional.
- Three (3) year experience in Acute Care, ICD-10-CM and CPT coding.
- One (1+) year experience in coding quality auditing.
- Demonstrates proficiency in Microsoft Office( products. The ability to develop spreadsheets and databases, and import/export files, etc.
- Previous experience with encoder software and EMR.
- Three plus year experience in coding quality auditing.
- Three (3) to five (5) year experience in Acute Care.
- Previous experience with compliance software.