高级认证程序员，门诊部 SDS-OBSV
Lead Certified Coder, Outpatient SDS-OBSV
位于萨克拉门托大都会区，安息日会健康公司总部自40多年前以来一直设在加利福尼亚州罗斯维尔。2019年，我们推出了获得WELL认证的园区——一个让全系统员工协作、创新和连接的焕新场所。
无论是在虚拟环境还是园区内，罗斯维尔安息日会健康公司及共享服务团队都能享受一个促进健康并激发最佳工作的欢迎空间。
职位概述：
审查SDS和OBV记录，以确定患者住院期间进行的诊断和操作代码是否有效，并符合编码惯例和指南。记录类型包括同一天手术和观察就诊类型。在定义的参数、既定指南和先例范围内处理常规任务。遵循既定程序，并接受日常工作指令。
职位要求：
教育和工作经验：
- 高中学历/GED或同等学历：必需
- 熟悉医院Cerner EMR（电子病历）：必需
- 5年SDS/OBV编码和医疗保健经验：必需
许可证/认证：
- AHIMA认证编码专家（CCS）：必需
核心职责：
- 审查APC和付款方拒付情况，并向领导和其他部门提供反馈。执行门诊审计，包括付款方审计和整体编码准确性审计。维护拒付和其他电子表格，以完成指定的拒付和审计职责。参加各种会议并提供编码反馈。研究并向门诊编码员工提供反馈和指导。确保编码更正和编辑得到更新。了解与编码和文档相关的法规变化，并将这些更新和变化传达给编码和领导层。为编码员工提供教育课程和培训资源。理解并协助领导和编码团队实现部门指标目标。从SDS和OBV患者记录中提取和分配ICD-10-CM诊断代码和CPT操作代码，以确保准确的APC分配，并为报销和统计数据提交提供所需信息。
- 核对SDS/OBV就诊中的服务日期与EMR中的文档是否一致。在SDS/OBV就诊的注册对话中完成OSHPD和其他数据提交所需的抽象字段。利用对修饰符使用的知识，确保准确性。
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Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Reviews SDS and OBV records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including same day surguery and observation encounter types. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work.
Job Requirements:
Education and Work Experience:
- High School Education/GED or equivalent: Required
- Working knowledge of hospital Cerner EMR (electronic medical record): Required
- Five years' SDS/OBV coding and health care experience: Required
Licenses/Certifications:
- AHIMA Certified Coding Specialist (CCS): Required
Essential Functions:
- Reviews APC and payor denials and provides feedback to leadership and other departments. Performs outpatient audits including payor audits and overall coding accuracy audits. Maintains denial and other spreadsheets for assigned denial and audit duties. Attends various meetings and provides coding feedback. Researches and provides feedback and direction to outpatient coding associates. Ensures coding corrections and edits are updated. Keeps abreast of regulatory changes related to coding and documentation and communicates these updates and changes to coding and leadership. Provides edicational sessions and training resources to coding associates. Understands and assists leadership and coding with reaching departmental metric goals. Abstracts and assigns ICD-10-CM diagnosis codes and CPT procedure codes from the SDS and OBV patient record to ensure accurate APC assignment and to provide information required for reimbursement and statistical data submissions.
- Validates appropriate dates of service against documentation in the EMR for SDS/OBV encounters. Completes required abstract fields in registration conversation on SDS/OBV encounter for OSHPD and other data submissions. Uses knowledge of modifier use to ensure accurate application on various payor types. Communicates with appropriate departments related to charge corrections/modifications. Audits medical records to ensure proper coding is completed and to ensure compliance with federal and state regulatory agencies. Follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies. Reviews, understands and applies quarterly coding clinics, coding guidelines and coding conventions of ICD-10-CM references. Collaborates to provide coding feedback and education to departmental leadership regarding completeness and accurateness of documentation and physician coding practices. Analyzes content of reports and software edits to facilitate revisions with appropriate departments - NCCI edits.
- Follows up coding holds, revenue cycle department holds including related and all other email communication.
- Collaborates to provide coding feedback and education to departmental leadership regarding completeness and accuracy of documentation and physician coding practices. Maintains required online Healthstream education courses.
- Attends meetings and training pertaining to coder education, audit reviews, staff meetings, outpatient coder roundtable meetings, and SDC to OBV charges.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
Originally posted on Himalayas