The Coding Specialist II is responsible for the accurate coding and assignment of Classification of Diseases, 9th Clinical Modification (ICD-9-CM) and/or Classification of Diseases, 10th, Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes to outpatient medical records for billing and statistical reporting. The coding is done in compliance with American Hospital Association (AHA) Coding Clinic Guidelines and the Centers for Medicare and Medicaid Services (CMS). This position is responsible for abstracting data from medical records in accordance with the Uniform Hospital Discharge Data Set (UHDDS), CMS and Bon Secours Health System requirements.

RESPONSIBILITIES:

• Assigns diagnosis and procedure codes according to the ICD-9-CM and/or ICD-10-CM and CPT and AHA Coding Clinic Guidelines with an accuracy of 95%.
• Maintains productivity levels. Abstracts data according to Uniform Hospital Discharge Data Set (UHDDS) and specific requirements. Interacts with Clinical Documentation Management Program personnel regarding documentation issues for coding.
• Queries appropriate personnel (i.e., physician, nurse practitioner, etc.)
• as necessary regarding documentation of diagnosis and/or procedure.
• Enters data necessary for reimbursement processes. Reviews and monitors coding/billing reports communicating to the System Coding Manager and/or Administrative Director of HIMS in a timely manner.
• Assists in compliance activities identifying areas of high risk in coding and documentation practices.
• Assists with the review of coding inquiries/denials as necessary.
• Keeps abreast of coding changes via attendance of educational sessions and review of publications.
• Assists in the collection and analysis of productivity data for the areas of responsibility for this position.
• Adheres to the Standards of Ethical Coding as set forth by the American Health Information Management Association.
• Adheres to the Bon Secours Code of Ethical and Legal Behavior, including completion of specific training and educational programs as deemed necessary for the position.
• Ensures delivery of excellent customer service resulting in positive and improving patient satisfaction scores for the department and Health System.
• Assists training as required of departmental staff and volunteers.
• Interacts with other health system personnel, Medical Staff Members, physician office personnel, and vendors as appropriate. Participates in departmental meetings.

QUALIFICATIONS/REQUIREMENTS:

Minimum two to four (2-4) years coding experience in an acute healthcare setting or proficiency in coding. Experience in a hospital/medical center preferred. Experience with computerized encoders and abstracting systems required. Experience with monitoring the discharged not final billed report preferred. Working knowledge of ICD-9-CM, ICD-10-CM, CPT, HCPCS and AHA Coding Clinic Guidelines. ICD-9-CM, ICD-10-CM, CPT courses. Certified Coding Specialist (CCS) Certified Professional Coder (CPC) required within one year of employment.

EDUCATION:

High school diploma or equivalent required.

OTHER:

If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

About Us:

Good Samaritan Hospital

Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the area's leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Children's Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.