The employee reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. The primary function of this position is to perform ICD 10-CM, ICD 10-PCS, CPT and HCPCS coding for reimbursement. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

• Abstracts all necessary information and assigns codes (ICD-10, CPT & HCPCS), which most accurately describe each documented diagnosis, surgical procedure and special therapy or procedure according to established guidelines.
• Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.
• Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established third party reimbursement agencies and special screening criteria.
• Analyzes provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code.
• Maintains effective relationships with internal and external entities such as the public, federal, state, and local agencies including: NLHD, Medicaid, Medicare, and other private insurance companies.

Values

i - Innovation

"Forward thinking" "Exploring new possibilities" "Ambitious Goals" Looks out for new and innovative approaches that will improve efficiency. Embraces and champions new ideas and encourages others to do likewise. Recognizes and rewards people and teams who are creative and innovative. This is in sharp contrast to those who tend to embrace the status quo, struggle with new approaches and discourage others when they are creative and innovative in the pursuit of increased efficiency or effectiveness.

C - Compassion

"Friendly countenance" "Servant attitude" "Demonstrating genuine concern" Shows genuine sensitivity to the needs, feelings and capabilities of other people. Deals with others in a pleasant manner. Treats others with respect and consideration. This is in contrast to those who are unpleasant and tend to alienate co-workers, or who seem insensitive to the needs of others and tend to demonstrate a lack of respect for others.

A - Accountability

"Showing integrity" "Leading by example" "Ownership and accepting responsibility" Acts in ways that demonstrate personal integrity and serves as a positive example of why others should trust the motives of the organization. Views himself or herself as a reflection of the organization by following through on commitments and accepting ownership of any mistakes he or she might make. Leaves others with the clear impression that integrity is a core value at this organization. This is in contrast to individuals who make commitments that go unmet, fail to acknowledge their role in disappointing events, or whose actions (or inaction) leave others with doubts about the level of trust that should be placed in the organization.

R - Respect

"Considerate of cultural diversity" "Building trust" "All people are to be valued" Demonstrates a genuine interest in the thoughts, opinions, values and needs of co-workers and customers. Avoids speaking, writing or doing other things that could be seen as disrespectful of people in their absence (or "behind their backs"). Recognizes and shows respect for the strengths and contributions of others. This is in clear contrast to behaviors that leave people feeling that their thoughts, opinions, values and needs are of little interest.

E - Empowerment

"Allowing others to reach their full potential: "Freedom to do what is right for our patients" "Attain and share knowledge to enrich others" Empowered in an intentional manner that allows the person to find their way, yet receiving help when needed. Using good judgment related to the level of authority given and the amount of leeway extended. This contrasts with leaders and individuals who focus more on the risks involved from the empowerment, instead of reaching the full potential of the organization.

Organization Expectations

Communication

The process of sending and receiving messages with words, verbally, written or in sign language.

Customer Focus

Identifying and responding to current and future patient and other customers’ needs; providing excellent service to internal and external patients and other customers.

Initiative

Identifying and dealing with issues proactively and persistently; seizing opportunities that arise.

Self-Development

Lifelong, voluntary, and self-motivated learning.

Teamwork

Effectively work and complete assignments in group settings. Works independently and cooperatively with others to achieve common goals.

Experience

Two years of coding experience using ICD 10-CM, ICD 10-PCS, CPT and HCPCS or equivalency preferred but not required.

Education

Completion of high school, or equivalent required

Licensure/Certification- Current

Certified Coding Specialist (CCS) Preferred

Certified Coding Specialist - Physician-Based (CCS-P) Preferred - or

Certified Professional Coder (CPC) Preferred

If you are a current employee or have previously worked for Nor-Lea Hospital District, please contact the Human Resources Department at hrgroup@nlgh.org for your correct username and password.