At Lahey Clinic, patient care always comes first. Because of our focus on excellence in patient care, Lahey Clinic continues to attract the best people across all departments and disciplines.
Job Description Including but not limited to: Meets all of the requirements for certification by a professional organization recognized by Coding leadership at Lahey Clinic. Attains and maintains professional certification. Reviews and interprets information from the medical record provided by physicians and other providers including progress notes, orders, operative notes/reports, pathology reports, nursing notes, medications, and other ancillary reports to obtain accurate diagnoses and procedures for reimbursement. Collaborates with physicians and providers to obtain diagnostic or procedural information as needed. Provides assistance with DRG related documentation and interpretation issues. Suggests sequence of diagnoses and procedures for optimal DRG assignment for reimbursement purposes. Provides appropriate professional surgical CPT-4 codes and modifiers on all Ambulatory Surgical procedures. Applies a thorough knowledge of medical terminology, anatomy & physiology and coding systems to code inpatient ambulatory surgical accounts in accordance with department, hospital, and regulatory requirements. Determines that the designation and sequence of primary and secondary diagnoses and procedures meets UHDDS definitions. Ensures that the application of codes is consistent with the rules and regulations established by the American Hospital Association Coding Clinic. Utilizes grouper software to calculate appropriate DRG for hospital reimbursement. (HFA and AP DRGs), and codes accordingly for Severity refined DRGs. Responsibilities Under the direction of the manager and exercising independent judgment within the scope of the job, performs a variety of duties related to the coding of inpatient hospital discharges for financial reimbursement, research and statistical purposes. Assures and validates appropriate CPT-4 for professional surgical services. Applies knowledge of specialized information specific to coding, medical terminology, and anatomy and physiology. The Certified Inpatient Hospital Coder achieves and maintains certification from a recognized professional organization, and applies a broader and more in-depth knowledge of coding to a variety of areas. Qualifications Education: High School Diploma or equivalent, plus additional specialized training associated with attainment of a recognized Coding Certificate from college level or accredited or approved program as recognized by AHIMA (American Health Information Medical Association) or AAPC (American Aceademy of Professional Coders). Licensure, Certification, Registration: Coding Certificate from College Level Coding Program (or equivalent), and CPC, or CCS, or CCS-P Skills, Knowledge & Abilities: Thorough knowledge of ICD-9-CM and CPT-4 coding, prospective payment principles, optimization techniques. Knowledge of CPT codeing for professional surgical services. Demonstrates a thorough understanding of the body of knowledge required for attainment of a college-level coding certificate as indicated above. Personal computer skills, including word processing, spreadsheets, data entry, researce, reporting, and accessing multiple hospital-wide systems. Excellent oral and written communication skills. Demonstrates proficiency as a teacher and/or educational resource to others in sharing knowledge and providing direction within the scope of the job. In the absence of certain of these skills, demonstrates the ability to be thoroughly trained to meet organizational requirements. Experience: 1 year inpatient/ambulatory coding is required. Shift DAYS, Mon - Fri