住院医院编码员
Inpatient Hospital Coder
Nemours 正在寻找一名佛罗里达州奥兰多市的住院部医院编码员
负责评估医院或专业环境中的服务记录内容，以准确编码主要诊断、次要状况、程序、社会决定因素代码，依据美国医院协会指南、当前操作程序术语指南、商业和/或医疗补助保险的特定付款人规则以及指定服务线的药物管理。需要具备独特才能和理解力，以从医院到专业业务流程中多个会话（即单一路径编码）分配代码，这些服务在同一服务日期、同一服务地点（POS）内，包括具有相同文档但不同代码分配的服务线（例如放射科），重点关注特定的排序实践。
核心职责
- 能够理解医疗记录文档，准确为每个活跃会话分配代码，涵盖多种专业领域。
- 满足所有分配 CPT 代码（医院和专业）的生产量和质量的最低要求。
- 需要掌握针对付款人特定规则的编码顺序，需注意细节以避免返工和浪费。
- 需要理解和应用 M.E.A.T. 标准（即监测、评估、评估、治疗），使用 ICD 10 CM 交易数据集来捕获诊断。
- 分析高风险会话，在会话完成前准确捕获费用并发现费用缺口（例如麻醉、手术的缺失费用），其中涉及手动费用捕获。
- 理解费用要求的复杂性，并将付款人特定趋势融入日常审查，以减少因护理不明确或缺乏依据而产生的“退回”情况。
- 通过实时互动促进临床文档修改，确保所记录的信息支持所提供的服务级别，关注慢性病、层级状况类别（HCC）和风险调整因素（RAF）。
- 能够常规地为医院和专业会话进行编码，作为日常工作的组成部分。
- 在三种或更多基于手术的产品线中表现出色：心脏外科、耳鼻喉科、普通外科/胃肠科、神经外科、整形外科和泌尿外科，具备出色的医院信息系统知识
查看英文原文
Nemours is seeking an Inpatient Hospital Coder in Orlando, FL
Responsible for assessing documentation content for service rendered in the hospital setting and/or professional setting in order to accurately code principal diagnoses, secondary conditions, procedures, social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines. Exhibits unique talent and comprehension in order to assign codes for multiple encounter/session (i.e. single path coding ) from Hospital to Professional lines of business process services which exist on the same date of service, in the same place of service (POS) include service lines which have the same documentation but different code assignments (i.e. radiology) with focus on specific ordering practices.
Essential Functions
- Ability to comprehend medical record documentation to accurately assign codes for each active session, in multiple specialties.
- Meets minimum requires for production and quality monthly for all procedure/surgeries assigned a CPT code (hospital and professional)
- Requires a working knowledge of code sequencing for payer specific rules which requires attention to detail to avoid rework and waste.
- Requires understanding and application of M.E.A.T. criteria (i.e. monitoring, evaluation, assessment, treatment) using ICD 10 CM transaction data set to capture diagnoses.
- Analyzes high-risk encounters for accurate charge capture and charge gaps prior to encounter completion (i.e. missing charges from anesthesia, surgery) where manual charge capture occurs.
- Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with un-clear, or un-substantiated care rendered.
- Facilitates modifications to clinical documentation through concurrent interaction to ensure that the information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC) and risk adjustment factors (RAF).
- Ability to code for hospital and professional sessions routinely as part of the daily work.
- Exhibits proficiency in all surgical coding three or more surgery based product lines: Cardiac, ENT, General Surgery/GI, Neurosurgery, Plastics, and Urology, with excellent working knowledge of hospital information system to retrieve data specific information (i.e. order diagnosis, patient type) within a complicated filing schema including non-hospital data (i.e. Media Tab, Office Visits etc)
Requirements
Associate's degree preferred
Medical Terminology, Anatomy and Physiology
One of the following: CCS, RHIT, RHIA; Preferred CRC
3-5 years experience
Originally posted on Himalayas