Senior Hospital Coder

Department/Unit:

Health Information Services

Work Shift:

Day (United States of America)

Salary Range:

$60,367.47 - $90,551.20

The Outpatient Senior Medical Coding Specialist (Emergency Department) will be responsible for performing coding quality audits on staff and providing thorough education and feedback to the medical coding specialists. They will be responsible for detailed reviews, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. They perform regularly scheduled audits as well as random audits. Complete duties as assigned by the Quality Manager, including writing appeal letters and following trends in denials. They inform management of trends and needs for improvement related to coding quality. They will work closely with the educator on developing training sessions and materials and working with the denial’s specialist for education and compliance. They optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases: code and abstract diagnostic and procedural information from physician documentation in the medical record using ICD-10-CM/PCS and CPT code sets. The senior thoroughly understands the hospital inpatient and outpatient and CBO billing and registration systems. Advises the coding staff of the appropriate registration patient types. This person will also be responsible for assisting in onboarding new staff.The Senior Medical Coding Specialist will be responsible for performing coding quality audits on staff and providing thorough education and feedback to the medical coding specialists. They will be responsible for detailed reviews, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. They perform regularly scheduled audits as well as random audits. Complete duties as assigned by the Quality Manager, including writing appeal letters and following trends in denials. They inform management of trends and needs for improvement related to coding quality. They will work closely with the educator on developing training sessions and materials and working with the denial’s specialist for education and compliance. They optimize hospital reimbursement by auditing and monitoring inpatient and outpatient records and investigating unbilled cases: code and abstract diagnostic and procedural information from physician documentation in the medical record using ICD-10-CM/PCS and CPT code sets. The senior thoroughly understands the hospital inpatient and outpatient and CBO billing and registration systems. Advises the coding staff of the appropriate registration patient types. This person will also be responsible for assisting in onboarding new staff.

3M 360 necessary. EPIC experience is a plus.

Applicants must receive a minimum score of 85% on a coding assessment.

Optimize hospital reimbursement by collecting and classifying diagnostic and procedural information from physicians and medical records. Responsible for the accurate and timely coding and abstracting of patient records using the ICD-10-CM and CPT classification systems. Ensures optimal reimbursement by applying all coding guidelines in the sequencing and assignment of codes. Interacts with providers to facilitate modifications to clinical documentation through the query process.

• Codes and abstracts patient records maintaining expected standards of accuracy (98%).

• Codes and abstracts patient records maintaining expected standards of productivity.
• Assists patient financial services personnel with coding/abstracting questions.
• Assists with the training/orientation of employees as requested by manager.
• Maintains coding/abstracting skills through participation in a variety of educational offerings, and review of current literature in paper and electronic form.
• Assists with monitoring the unbilled report, resolves issues and prioritizes work to maintain established accounts receivable targets.
• Participates in the coding subcommittee groups actively contributing to the list of agenda items, resolution of issues and development of coding guidelines/quick reference guides.
• Assign evaluation and management (E&M) codes and CPT procedure codes for Emergency Department Physician Professional services and technical components.
• Resolve edits on error worklis working with Patient Billing and Finance

• Assign ICD-10 diagnosis codes on radiology, recurring, observation and dialysis encounters as requested.
• Maintain patient confidentiality.
• Participate in training as required.
• Perform other duties as assigned.

Credential and Education:

• AHIMA and or AAPC Credentials
• Credentials as CCS, CPC required
• High School Diploma or GED. Preferred associates degree or progress towards a degree in Health Information Technology or Health Information Management

Experience:

• Minimum 7 years coding experience or five years' experience with an HIM-related associate degree or higher
• Experience in Evaluation and Management Coding for Professional Emergency Visits
• Experience in Injection and Infusion Coding
• 3M 360 and EPIC experience preferred
• Ability to use a computerized medical record abstract and encoder.
• Excellent command of the ICD-10-CM/PCS and CPT4 classification systems and DRG, APC and APG methodology.
• Experience working with CDI
• Must be able to understand and comply with policies and procedures
• Ability to multi-task while utilizing multiple screens
• Strong computer skills with the ability to learn multiple EMR systems as well as data reporting systems

• Demonstrated excellent communication skills.
• Maintains high coding quality and productivity as established by the department

**Fully Remote**

**Out of State Eligible

Thank you for your interest in Albany Medical Center!​

Albany Medical is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.