Health Information Services Coder I/II - Physician Enterprise - Full Time

Job Description

The estimated pay for this position is $23.8776 to $38.2097 per hour. The rates shown include a 6% premium pay (base= $-$ plus 6%). This reflects only a portion of the total compensation package for this position. Additional compensation may be available for this role through differentials, incentives, and bonuses. In addition, this position may be eligible for participation and company contributions into the Kern County Employees’ Retirement Plan.

Employment Standards

• Level I: One year of diagnostic and procedure coding experience in a hospital, health care facility, or physician's office. OR Completion of a medical coding program whereby the necessary skills were obtained to successfully perform the essential functions of the job.
• Level II: Three years of diagnostic and procedure coding experience in a hospital, health care facility or physician's office. OR Current registration as a Certified Coding Specialist (CCS) by the American Health Information Management Association.

Distinguishing Characteristics

• Level I: Essential Functions: Codes and abstracts routine to complex patient medical record information according to the International Classification of Diseases Clinical Modification Systems (ICD) and the current procedure terminology (CPT) Manual and coding conventions and guidelines as established by the Coding Clinic and Office of Statewide Planning Health Department (OSHPD) reporting requirements. Assists with statewide Office of Statewide Health Planning Department (OSHPD) reporting by determining accurate identification of the Diagnostic Related Group (DRG) for proper reimbursement. Assists in compiling statistical data for hospital reporting. Assists in training less experienced coders. Reviews medical record documentation/information and verifies coding and DRG assignments in response to billing requests. Responds to authorized requests from agencies, administration and individuals regarding DRG, coding questions or concerns. Maintains a working knowledge of current guidelines and regulations affecting code assignments through continuing education sessions and approved references such as journals, workshops and teleconferences. Performs other job related duties as required.
• Level II: Essential Functions: Codes and abstracts complex patient medical record information according to the International Classification of Diseases Clinical Modification Systems (ICD) and the current procedure terminology (CPT) Manual and coding conventions and guidelines as established by the Coding Clinic and Office of Statewide Planning Health Department (OSHPD) reporting requirements. Assists with statewide Office of Statewide Health Planning Department(OSHPD)reporting by determining accurate identification of the Diagnostic RelatedGroup (DRG) for proper reimbursement. Assists in compiling statistical data for hospital reporting. Assists in training less experienced coders. Reviews medical record documentation/information and verifies coding and DRGassignments in response to billing requests. Responds to authorized requests from agencies, administration and individuals regarding DRG, coding questions or concerns. Maintains a working knowledge of current guidelines and regulations affecting code.Assignments through continuing education sessions and approved references such as journals, workshops and teleconferences. Performs other job-related duties as required.

Knowledge Of

• Standards and regulations pertaining to the maintenance of patient medical records; medical records coding systems; medical terminology; anatomy and physiology and study of diseases; health information systems for computer application to medical records.

Ability To

• Utilize the ICD classification system to code medical record entries; abstract information from medical records; read medical record notes and reports; set accurate Diagnostic Related Groups; comply with the American Health Information Management Associate’s Code of Ethics and Standards of Ethical Coding and applicable Uniform Hospital Discharge Data Set (UHDDS) standards; use computers and various software to accomplish work.