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Coding & Quality Specialist

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POST DATE 9/7/2016
END DATE 10/29/2016

Lutheran Senior Services Saint Louis, MO

Company
Lutheran Senior Services
Job Classification
Full Time
Company Ref #
4644
AJE Ref #
576109276
Location
Saint Louis, MO
Experience
Entry Level (0 - 2 years)
Job Type
Regular
Education
High School Diploma or GED

JOB DESCRIPTION

APPLY
JOB DESCRIPTION:

SUMMARY:

The Coding & Quality Specialist is responsible for reviewing and analyzing documentation provided on admission and in the medical record to determine the diagnosis as described by the physician(s) of record. Adheres to official coding guidelines and abides by the Standards of Ethical Coding set for by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC).

The Coding& Quality Specialist upholds the philosophy, vision, and core values of the organization and ensures the Christian Mission of Lutheran Senior Services is realized so that Older Adults Live Life to the Fullest .

ESSENTIAL DUTIES AND RESPONSIBILITIES:

* Responsible for the review of Care Center, Assisted Living, and Home and Community Based Services (HCBS) medical records on admission with assignment of the appropriate ICD-10-CM codes consistent with LSS Coding Policies and for ensuring accurate reimbursement.

* Responsible for collecting, analyzing, assigning and sequencing all necessary diagnosis codes according to the latest coding system update(s).

* Collaborates with community s MDS Coordinator and participates in the CCRC triple-check process to ensure compliance with established third party reimbursement agencies and special screening criteria.

* Completes an HCBS admission review of OASIS assessments and other pertinent clinical documentation and collaborates with HCBS visiting nurse(s) to obtain or clarify diagnoses.

* Queries clinicians when code assignments are not straightforward or documentation is inadequate for coding purposes.

* Performs quarterly audits of Assisted Living and Long-Term Care resident s codes and ensures diagnose codes are current and reflects updated care plan documentation.

* Meets daily productions goals as defined by the Director of Health Information Management

* Maintains an average of 95% accuracy rate on a monthly basis as defined by the LSS Coding Policy.

* Monitor s delinquent or missing documentation within the CCRC/HCBS and notifies the Health Information Coordinator.

* Acts as a resource to clinical reimbursement and billing staff.

* Promotes individual professional growth and development by meeting requirements for continuing education; supports team and department-based goals contributing to the success of the organization.

QUALIFICATIONS, KNOWLEDGE, SKILLS & ABILITIES:

Minimum of 1 year ICD-9 coding related experience and ICD-10 training preferred.

High School diploma (GED) with applicable coding experience required; Associates Degree in medical coding, health information technology or other related field from an accredited program preferred.

Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.

Willing to obtain Home Care Coding Specialist Diagnosis (HCS-D) and Certification for OASIS Specialist Clinical (COS-C) credential(s) within one year of hire.

Experience in the use of an EHR and Encoder Software

Ability to manage time and organize daily schedule to meet productivity and accuracy standards.

Strong communication skills

Proficient computer skills

OTHER QUALIFICATIONS:

Lutheran Senior Services (LSS) requires drivers of licensed company vehicles and those using their own vehicles for business purposes have the appropriate driver s license, insurance coverage, and meet the auto liability carrier s driver s criteria.

PHYSICAL ACTIVITIES AND WORKING ENVIRONMENT:

The physical activities and demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; and talk to hear. The employee frequently is required to sit; reach with hands and arms; and stoop, kneel, crouch, or crawl. The employee is occasionally required to climb or balance.

Must be able to move intermittently throughout the work day.

Must be able to lift up to 30 pounds.

Normal working hours M-F 8am-5pm, rotating weekends

A well-lighted and ventilated working area that has its own temperature control system (air conditioning and heat).

Is subject to frequent interruptions.

Occasional travel from facility to facility may be required.

The noise level in the work environment is usually moderate.

This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees may be required to follow other job-related instructions and to perform other job-related duties as requested, subject to all applicable federal, state and local laws and standards.

JOB FAMILY:

Administration

SCHEDULED WEEKLY HOURS:

40

WORK SHIFT:

Day Shift (United States of America)","value":"

JOB DESCRIPTION:

SUMMARY:

The Coding & Quality Specialist is responsible for reviewing and analyzing documentation provided on admission and in the medical record to determine the diagnosis as described by the physician(s) of record. Adheres to official coding guidelines and abides by the Standards of Ethical Coding set for by the American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC).

The Coding& Quality Specialist upholds the philosophy, vision, and core values of the organization and ensures the Christian Mission of Lutheran Senior Services is realized so that Older Adults Live Life to the Fullest .

ESSENTIAL DUTIES AND RESPONSIBILITIES:

* Responsible for the review of Care Center, Assisted Living, and Home and Community Based Services (HCBS) medical records on admission with assignment of the appropriate ICD-10-CM codes consistent with LSS Coding Policies and for ensuring accurate reimbursement.

* Responsible for collecting, analyzing, assigning and sequencing all necessary diagnosis codes according to the latest coding system update(s).

* Collaborates with community s MDS Coordinator and participates in the CCRC triple-check process to ensure compliance with established third party reimbursement agencies and special screening criteria.

* Completes an HCBS admission review of OASIS assessments and other pertinent clinical documentation and collaborates with HCBS visiting nurse(s) to obtain or clarify diagnoses.

* Queries clinicians when code assignments are not straightforward or documentation is inadequate for coding purposes.

* Performs quarterly audits of Assisted Living and Long-Term Care resident s codes and ensures diagnose codes are current and reflects updated care plan documentation.

* Meets daily productions goals as defined by the Director of Health Information Management

* Maintains an average of 95% accuracy rate on a monthly basis as defined by the LSS Coding Policy.

* Monitor s delinquent or missing documentation within the CCRC/HCBS and notifies the Health Information Coordinator.

* Acts as a resource to clinical reimbursement and billing staff.

* Promotes individual professional growth and development by meeting requirements for continuing education; supports team and department-based goals contributing to the success of the organization.

QUALIFICATIONS, KNOWLEDGE, SKILLS & ABILITIES:

Minimum of 1 year ICD-9 coding related experience and ICD-10 training preferred.

High School diploma (GED) with applicable coding experience required; Associates Degree in medical coding, health information technology or other related field from an accredited program preferred.

Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.

Willing to obtain Home Care Coding Specialist Diagnosis (HCS-D) and