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Senior Hospital Coder - HIM Hospital Coding

Job ID: 8297
Location: Chapel Hill, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job

Did you know UNC Health has Ranked #2 Most Trusted Healthcare Brand in the U.S.? The UNC Health brand was ranked as the #4 healthcare brand in the United States overall and the #2 most trusted healthcare brand, just after Johns Hopkins and before Mass General. Join our One-Great-Team!

Job Description

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

Performs the same duties as Medical Coder I and II – Hosp IP and Medical Coder I, II, III – Hosp OP, but also serves as a resource for Medical Coders (IP and OP) when needed on complex application of codes. Participates in and mentors coders, provides problem resolution and feedback to supervisors. Assists and serves as back-up to the Medical Coder Auditor – Hosp IP &OP as needed on completing PWC SMART coding edits.

Responsibilities:

1. Assigns and/or audits International Classification of Diseases 10-CM (ICD-10) diagnostic and ICD-10-PCS procedural codes, Current Procedural Terminology (CPT) codes with modifiers, and other applicable codes in an accurate and productive manner on inpatient, outpatient (observation, ambulatory surgery, and ancillary cases).
2. Queries providers when documentation is conflicting, needs clarification and specificity.
3. Groups codes and completed product into payment group.
4. Analyzes information for optimal and proper reimbursement.
5. Ensures compliance with all appropriate coding, billing and data collection regulations and procedures.
6. Reviews work of staff as needed. Responds to questions and refers staff as appropriate to the Medical Coder Auditor.
7. Researches and resolves problems from coders as needed.
8. Provides input on performance of coders to supervisor for performance evaluations.
9. Performs coding audits at a minimum of two medical coders per month as needed to back up the Medical Coder Auditors – Hosp IP/OP.
10. Researches and resolves problems referred by coders in response to audited charts. Provides information on performance of coders’ audits to supervisors.
11. Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
12. Provides training and serves as a general resource to assist other coders and members of department staff.
13. Reviews, analyzes and abstracts physician/other documentation for diagnoses, procedures, ancillary testing, medications, laboratory and other services provided. Communicates with physicians and other health care staff to obtain missing information or to clarify existing information.
14. Reviews and processes PWC SMART edits.
15. Utilizes a variety of software (e.g. EPIC, Optum CAC, PWC SMART, etc.) to compile and validate medical information.

Job Requirements:

  • Associate’s degree in Health Information Management, Nursing or related field or an equivalent combination of education, training, and experience.
  • If Associate’s degree: Three (3) years of experience in Inpatient and Outpatient hospital coding.
  • If High School Diploma: Seven (7) years of experience in Inpatient and Outpatient hospital coding.
  • Successful completion of the UNC HCS Inpatient and Outpatient Coder Proficiency Test.
  • Must have AHIMA (American Health Information Management Association) certification and credentialORAAPC (American Academy of Professional Coders) certification and credential
  • Strong knowledge of ICD-10/PCS/CPT/HCPCS coding with excellent analytical and data mining skills. 
  • Ability to effectively manage projects, plan and implement programs, and evaluate outcomes, and effectively work with direct various levels of staff (including on-site and remote) and mentoring colleagues. 
  • Effective organizational skills, time management, and management of multiple priorities. 
  • Ability to interpret complex medical conditions and work with complex coding applications. 
  • Ability to interpret federal and state regulations as they relate to coding and compliance.
  • Excellent balance of being highly productive and yet produce high quality work. 
  • Strong communication skills, both written and verbal and have extensive attention to detail. 

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care. This is not a State employed position.
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Diversity Statement

The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.

Equal Employment Opportunity

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