Job Descriptions

Job purpose/summary

This role is work at home with standard business hours required. This role will be home-based and have some flexibility of work schedule. This role would ideally suit someone who enjoys being able to manage their workload, whilst also functioning well as part of a wider team.

Duties and responsibilities

The ideal candidate will be responsible for:

• Performing a comprehensive review of the patient record to abstract medical, surgical, ancillary, demographic, social, and administrative data to ensure complete data capture
• Completing clinical documentation improvement process including querying providers as deemed necessary
• Holding primary responsibility for answering coding questions and updating interdisciplinary team about coding and documentation updates and internal and industry process and guideline changes
• Providing compliance and process-related recommendations on medical coding issues
• Reviewing clinical documentation to assign diagnostic and procedural codes for inpatient and outpatient medical records according to the appropriate classification system
• Performing ongoing analysis of medical charts to ensure all codes are reported timely and properly to CMS

Competencies

The ideal candidate will demonstrate competencies in the following areas:

• Performing accurate analysis of medical records to obtain necessary information for the appropriate sequencing and assignment of
• Providing technical support in the areas of regulations and policy, coding requirements, resident supervision, reimbursement, workload, accepted nomenclature, and proper sequencing
• Performing ongoing analysis of medical record charts for the appropriate coding compliance
• Identifying clinical information from the medical record for reimbursement, research, and compliance with federal regulations and other agencies using established coding principles and protocols
• Demonstrating analytical and problem-solving ability regarding review of submitted diagnosis codes versus actual services provided to the patient
• Analyzing provider documentation to assign appropriate evaluation and management levels
• Interpreting progress notes, operative reports, and charge documents to determine services provided and accurately assigning coding to these services
• Meeting coding deadlines to expedite the billing process and to facilitating data retrieval for physician and ongoing care
• Time Management
• Medical Management
• Process Management
• Information Management
• Learning Management
• Health Management
• Content Management System
• Benefits Management
• Healthcare Management
• Cost Management
• Data Management
• Business Management
• Case Management
• Financial Management

Tools and technologies

• Web-based Software
• Embedded Services
• Microsoft Applications
• Microsoft Windows
• Microsoft Access
• Microsoft Office
• Microsoft Excel
• Microsoft PowerPoint
• Microsoft Suite
• Microsoft SQL Server
• Microsoft Word
• Microsoft Outlook
• Adobe Creative Cloud
• Adobe Experience Manager
• computer applications
• web applications
• Adobe Photoshop

Reporting relationship

To be completed by the user of this job description as appropriate

Direct reports (if appropriate)

To be completed by the user of this job description as appropriate

Qualifications

Education

To be completed by the user of this job description as appropriate

Certifications

To be completed by the user of this job description as appropriate

Other relevant qualifications

To be completed by the user of this job description as appropriate

Key Attributes

To be completed by the user of this job description as appropriate

Experience

To be completed by the user of this job description as appropriate

Working conditions (if required)

If the job requires a person to work in special working conditions this should be stated in the job description. Special working conditions cover a range of circumstances from regular evening and weekend work, shift work, working outdoors, working with challenging clients, and so forth.

Physical requirements (if appropriate)

If the job is physically demanding, this should be stated in the job description. A physically demanding job is one where the incumbent is required to stand for extended periods, lift heavy objects regularly, do repetitive tasks with few breaks, and so forth.