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Company Profile:
At PeaceHealth, we carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way. The fulfillment of this Mission is our shared purpose. It drives all that we are and all that we do. To those who embrace the spirit of these words and our commitment to Exceptional Medicine and Compassionate Care, we offer the opportunity to learn and grow as a member of the PeaceHealth family.

Job Description:
Analyzes the ER record for completeness. Validates purpose and enters correct CPT & EM Codes for professional and facility charges. Assists with the maintenance of KGH Medical Transports log and forms. Assists with the data entry and Employee Health records maintenance. Performs qualitative and quantitative review of the ER and Employee Health medical record, ensuring a complete and accurate record. All duties are performed in a manner consistent with the standards and values of KGH.

POSITION REQUIREMENTS

1. Education: High school diploma or equivalent. Knowledge of medical terminology and abbreviates required. Work experience may be substituted in part for formal education. Knowledge of CPT-4 and ICD-9 coding required.

2. Certification: Certified Coder. Requires RHIT professional with CCS preferred

3. Experience: Has a certified coding certificate or experience as follows. Requires a minimum of one year's clerical experience in hospital medical record/health information department. Two years of full time experience in a physician medical office can be substituted. One semester of college-level anatomy and physiology class is necessary. One or more years of college-level preparatory health information/nursing/medicine/or other clinical coursework is desired. Related health information and/or medical academia can be substituted for the experience in some cases. Knowledge of federal and state health facilities regulations is preferred. Knowledge of Joint Commission regulations and other applicable health information industry standards are preferred. Must have PC data entry and PC word processing experience. Must be knowledgeable about hospital health information management systems. Knowledge of billing regulations, insurance coverage limitations and managed care protocols preferred. Experience providing one-on-one feedback to clinical providers preferred.

4. Interpersonal: Must be an emotionally mature individual who is able to demonstrate interpersonal and communication skills to work cooperatively with coworkers, physicians and other hospital departments, patients and visitors. Must have excellent organizational skills and possess the ability to make responsible decisions under difficult situations. Must be capable of maintaining a high degree of confidentiality and diplomacy. Proven ability to work with minimal supervision at a high level of productivity. Must be able to communicate both verbally and in writing in a highly professional manner. Must be able to prioritize own work and proceed with a minimum of supervision. Must be punctual and maintain an excellent attendance record. Ability to maintain professional attitude at all times.


5. Physical: Must have ability to tolerate long periods of sitting, at times throughout an entire shift except for beaks and meal periods; must be able to stand for long periods at a photocopy machine; use keyboard with sufficient dexterity for speed required by job; read computer screen text at times for extended periods; lift supplies weighing up to 50 pounds occasionally with assistance as necessary; bend and reach to file and retrieve records; hear and speak with individuals in person or on the telephone; read and write text. Position requires close attention to detail and ability to handle multiple tasks simultaneously, telephone and face-to-face contact with other staff and external contacts, viewing a computer monitor and reading computer printed reports, ad ability to meet deadlines and work with frequent interruptions. Continuous attention to detail required. Must be able to function under pressure.


ESSENTIAL DUTIES


1. Each day retrieves the ER charts from the previous day. Verifies all of the ER charts are accounted for by comparing charts to the ER Log. Sort's charts into alpha order, if not already in that order. Assembles charts into an organized order. Removes any MD office/clinic chart copies and routes to the respective office/clinic. Removes any insurance forms (i.e..e., workman's compensation, fish fund forms), routing to appropriate destination after logging a comment into the patients record in the account doc section. Also tracks incomplete forms until completed.

2. Analyzes each chart for quality charting or indicators using established criteria on specific topics or chart requirements. I.e., ER indicators, signatures, appropriate forms, appropriate acuity, times in/out match ER paper chart, correct physician. Seeks clarification on any questionable charting concern from staff involved.

3. Corrects data entry errors or lacking entries as needed. I.e., time in/out, acuity, disposition, and physicians.

4. Conducts a review of each ER chart. Assures that all services documented in the patient's chart are coded with appropriate CPT-4 and possibly ICD-9 codes. Validates and corrects all ER pro, facility and medical transport charges by review of the ER written chart and or dictation. This is done in accordance with correct coding guidelines established by the American Medical Association (AMA) and CMS prior to posting the data using current KGH charge-master codes.

5. When services are not documented appropriately, seeks to attain proper documentation in a timely manner. Changes and or modifications are done with consults and clarifications with the both the nursing and physician clinical providers. Requires review of physician documentation and working of the ER error queue (T-System to Care Cast interface). Logging of awaiting entries.

6. Conducts a review of records to insure compliance with coding and documentation guidelines and governmental requirements. Provides reports to manager.

7. Provides accurate answers to physicians and facility coding and/or billing questions on a timely basis.

8. Entered computer charge data entries are verified with the daily RMS-10 report. Errors are corrected appropriately. This process is completed within the allotted time frame.

9. Keeps current with changes within the coding field to provide the highest quality of specificity of coding for professional and facility service as allowed by the correct coding Initiative guidelines. Consults and requests from the appropriate source the new charge-master items to update the charge-master for KGH.

10. Reviews the medical record and Care Cast to validate Pyxsis billing summary with the patient's charted drug usage and wastes. Supplies the pharmacy with corrections and additions to capture all possible revenue and provide an accurate statement of usage, i.e..e., account numbers and drugs used that do not show in Pyxis due to the daily downtime. Assists with Pyxis discrepancy reports, using last word, chart searching and nursing staff consultations.

11. Each day retrieves the KGH medical transport charts/forms from the transport log book from the prior day. Enters the medical transports into the Care Cast log and the ER tracking log. Sends forms to appropriate destinations. Has registration create accounts as is needed.

12. Maintains a working knowledge of the billing system, the registration process and charge entry.

13. Works with other members of the central billing office to assures maximum efficiency and reimbursement for properly documented services.

14. Reviews, modifies and recommends changes to policies and procedures to improve professional and facility fee coding and data management.

15. Processes emergency department records according to department procedure.

16. Takes the ER charts (by 24 hour admit day) to HIM ER Desk.

17. Provides daily an ER physician charge report, transport report, an ER log with all of the ER encounters and a QI log.

18. Assists with data entry record keeping, immunization entry and processing of Employee Health records. Obtains a medical record number for each employee. Tracks and notifies employees of impending testing or immunizations. Also tracks and logs laboratory and radiology reports. Assists with special EH projects; i.e..e.; annual EH screens, flu vaccine.

19. Gathers and submits required by weekly and monthly statistical reports to appropriate sources.

20. Assists in the QM process as directed. Participates in specialized and/or focused reviews of charts, during analysis, for specific QM purposes.

21. Ensures own professional effectiveness through continuing education and professional development. Maintains a working knowledge of CPT and ICD-9 coding principles, governmental regulations, protocols and third party requirements regarding billing and billing documentation.

22. Conducts one-on-one or small group education to physicians and facility regarding the current and updated information.

23. Maintains strict confidentiality regarding patients and employees.

24. Maintains professional image, observes KGH dress code, and wears proper identification badge at all times.

25. Achieves goals each year as listed on the annual performance review.

26. Performs all duties in a manner consistent with standards, values and mission of KGH.

27. Adheres to all safety policies to ensure a safe environment for self, co-workers, patients, and visitors.

28. Assists with other department functions as oriented and needed.

Qualifications:
Please see above.