The Senior Coder is responsible for accurately assigning diagnosis and procedure codes, MS-DRGs, and APCs while validating charges against health record documentation. They also collaborate with clinical staff and physicians to resolve documentation issues and ensure compliance with coding and reimbursement regulations.
Requirements summary
Candidates must have at least a high school diploma or GED with 3 years of experience, or an associate degree/coding certification with 1 year of experience. Proficiency in medical coding systems, reimbursement regulations, and strong analytical skills are required for this role.
high schoolassociate degreeprofessional certificateCommunication skillsProblem-solvingICD-10-CMAPCICD-10-PCSCPT/HCPCSData analysisMS-DRGMedical terminologyAnatomy and physiologyBilling practicesMedical codingReimbursement regulationsDocumentation validationCharge description masterConcurrent coding reviews
Job description
Your job is more than a job SPECIALTIES ENT/General Surgery/Plastic Surgery/Dermatology GENERAL DUTIES Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs assignment and all required modifiers.
Validates charges by comparing charges with health record documentation as necessary.
Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
Identifies concerns and notifies appropriate leadership for resolution.
Responsible for providing resolution to moderate to complex problems.
Tracks issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion.
Consistently meets or exceeds coding quality and productivity standards established by coding department.
Adheres to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information.
Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
Performs other duties as assigned by leadership.
Maintains working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
EDUCATION/EXPERIENCE QUALIFICATIONS Required: High School Diploma/GED or equivalent and 3 years of work experience, or Associate’s and 1 year of experience, or Diploma/Certification in Coding and 1 year of experience.
Preferred
Associate's Degree in HIM or similar or Completion of AHIMA Approved coding program or AAPC coding program. LICENSES AND
Certifications
A certification in the following areas is also preferred: Registered Health Information Technician from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA Registered Health Information Administrator from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA Certified Coding Specialist from the Commission on Certification for Health Informatics and Information Management (CCHIIM) KNOWLEDGE, SKILLS, AND ABILITIES Comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping and components of charge description master for charging functions. Must possess knowledge of third party reimbursement regulations and billing practices. Experience utilizing encoding/grouping software. Ability to use standard desktop and windows based computer system, including basic understanding of email, internet, and computer navigation. High ethical standards. Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines. Experience in ICD-10-CM/PCS coding and reimbursement training. Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters. Knowledge of hospital and professional coding including provider-based billing. Knowledge of documentation regulations of Joint Commission and CMS. Experience with concurrent coding reviews. Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices. Experience in assisting and identifying learning needs as well as providing training to coding staff. Strong analytical abilities and problem-solving skills. Excellent oral, written and interpersonal communication skills. Ability to organize and set priorities to ensure objectives are met in a timely manner. Ability to adapt to change and handle challenges proactively and with pose. Ability to effectively collaborate with physicians and managerial staff at all levels.
WORK
SHIFT: Variable Hours (United States of America) LCMC Health is a community. Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary Your extras Deliver healthcare with heart. Give people a reason to smile. Put a little love in your work. Be honest and real, but with compassion. Bring some lagniappe into everything you do. Forget one-size-fits-all, think one-of-a-kind care. See opportunities, not problems – it’s all about perspective. Cheerlead ideas, differences, and each other. Love what makes you, you - because we do You are welcome here. LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Simple things make the difference. 1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information. 2. To ensure quality care and service, we may use information on your application to verify your previous employment and background. 3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed. 4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States. About LCMC Health One-of-a-kind care comes from one-of-a-kind people. At LCMC Health, our people are the magic ingredient that makes our care so extra-extraordinary. We are compassionate, driven, and dedicated to bringing a little something extra to healthcare and to the people of New Orleans and beyond. If you’re the kind of person who believes that our community deserves the best and that healthcare needs a little more heart, we want you to be a part of our family. From medical roles to administrative positions, every person on our team plays a part in our mission: to provide health, care, and education beyond extraordinary. Let’s make every day extraordinary, together.
