The Coder I will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement. Specialists validate APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record. The Coder I performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder I may interact with client staff and providers.
- Select and sequence ICD-9, ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management.
- Review and analyze clinical records to ensure that APC assignments accurately reflect the diagnoses/procedures documented in the clinical record.
- Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
- Complete assigned work functions utilizing appropriate resources.
- May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries Coding Associate.
- Maintain strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release of information.
- Participate in client and Precyse staff meetings, trainings, and conference calls as requested and/or required.
- Maintain current working knowledge of ICD-9 and ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
- Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
- Support Precyse’s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient and/or client information.
- Active RHIA or RHIT or CCS, CCA, COC (formerly CPC-H), CCS-P, CPC
- One (1) year of recent and relevant hands-on coding experience
- Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-9/10 and CPT/HCPCS code sets (knowledge of ICD-10 code set required effective October 1, 2015)
- Ability to consistently code at 95% threshold for both accuracy and quality while maintaining client-specific and/or Precyse production and/or quality standards
- Proficient computer knowledge including MS Office (Outlook, Word, Excel)
- Must display excellent interpersonal and problem solving skills with all levels of internal and external customers
- Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience
nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse, Equation and Adreima, each formerly a leader in its own right, we’ve combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.
nThrive is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
How to Apply