Professional Coder

Summary :

The Professional Coder is an expert in managing patient health information and medical records, administering computer information systems, collecting and analyzing patient data, and using classification systems and medical terminologies. Possesses comprehensive knowledge of medical, administrative, ethical and legal requirements and standards related to healthcare delivery and the privacy of protected patient information. Interacts with all levels of an organization - clinical, financial, administrative, and information systems - that employ patient data

in decision-making and everyday operations.

The Professional Coder is an expert in health information documentation, data integrity, and quality. Professional Coder classifies medical data from patient records, reviews patients' records and assigns numeric codes for each diagnosis. In addition, possesses expertise in the ICD-10-CM and CPT coding systems and responsible for auditing of appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. The Professional Coder ensures that integrity of data posted within the Revenue Cycle adheres to policies and compliance. The Professional Coder ensures optimal coding is associated with medical records, data integrity, and quality of documentation is met.

Job Duties & Responsibilities :

• Applies the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing.
• Abstracts pertinent information from patient records. Assigns the International Classification of Diseases (ICD), Clinical Modification, Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments.
• Obtains acceptable productivity / quality rates as defined per position expectations.
• Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
• Review of medical records concurrently prior to claim submission.
• Keeps abreast of and complies with coding guidelines and reimbursement reporting requirements.

Coordinate with management to Audit all aspects of Electronic Health Record

Identify opportunities for improvement

Participate in the Rogers Improvement System (RIS) program

Assist in promoting a team atmosphere by treating individuals with respect and honesty and by using direct communication and active listening skills

Demonstrate understanding of Joint Commission and other regulatory agency compliance regulations

Participate in RBH committees, RIS team meetings, and team projects, as directed

Conduct self in a professional manner

Additional Job Description :

Education / Training Requirements :

Must be located in one of our states of operation.

States of operation : California, Colorado, Florida, Georgia, Illinois, Minnesota, Pennsylvania, Tennessee, Washington, and Wisconsin

Certified Professional Coder - Cert, Registered Health Info Administrator - Cert, Registered Health Info Technician - Cert

With a career at Rogers, you can look forward to a Total Rewards package of benefits, including :

Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Rogers Behavioral Health. To link to the Machine-Readable Files, please visit Transparency in Coverage (uhc.com)