Charge Entry Analyst and Coder

Scope of Position

The Charge Entry Analyst and Coder will be accountable for reviewing and posting all surgical logs within Labor and Delivery for accuracy of documentation and timeliness, reviewing the birth log for vaginal delivery charges and documentation, and reviewing/reconciling/entering facility and professional charges for Obstetrics Emergency Department (OB ED). This includes contacting the appropriate individuals to ensure documentation is efficient and to reconcile the patient account/surgical logs. The Charge Entry Analyst and Coder will also utilize and review daily reports for appropriate charges, compliance, and will work with appropriate staff and departments on education when needed. The Charge Entry Analyst and Coder must have the ability to communicate effectively and professionally both written and verbally, the ability to meet deadlines, and maintain strict confidentiality of all patients and staff/faculty information.

Position Summary

The Charge Entry Analyst and Coder will support the department by reconciling all coding and professional/facility capturing and missed revenue in the OB ED. Codes are applied to procedures/encounters and flow to EPIC/IHIS Resolute Billing system. The Charge Entry Analyst and Coder will also support the review of all delivery logs for vaginal birth charges, review appropriate level of care charges, post and reconcile the OR Lamp;D log, mitigate and provide education for documentation errors related to charging, and perform all other duties or special projects as assigned.

55% Charge Capture/Documentation/Reconciling

• Partners with Revenue Integrity to ensure facility charges in the OB ED are entered/posted in accordance with required timelines; certifies accuracy of documentation.
• Partners with OSUP Revenue Integrity and Coding to review all professional charges in the OB ED and drop charges in accordance with required timelines; certifies accuracy of documentation.
• Ensures that the department is compliant with rules for the assignment of all coding/claim level modifiers for encounters.
• Regularly reviews/audits IHIS reports for OB ED charge opportunities/reconciliation.
• Provides monthly reporting of frequently encountered errors and education to mitigate.
• Reviews Revenue Integrity reports to ensure vaginal delivery charges appropriately dropped.
• Reviews bed charges for accuracy as well as accurate/appropriate level of care charges are entered.
• Works with CDI team to enhance OB/GYN Department CC/MCC Capture Rate.
• Reviews CDI queries report and work with providers for the appropriate response.

30% OR Log Posting

• Troubleshoots log errors and warnings by reviewing patient encounter for missing or incorrect information and contacts appropriate entity (if applicable) for resolution.
• Reviews and posts the Labor and Delivery Surgical Log for accurate charges, supplies, and documentation while working with clinical staff to ensure corrections to documentation are made.
• Works with clinical staff, Supply Chain, Revenue Management, or Anesthesiology to audit charge amounts, supplies, and timestamp details to verify accuracy.

15% Customer Service/Back-up/Other Duties as Assigned

• Participates in departmental staff meetings, charge capture staff meetings, nursing staff meetings, and all others as required and as pertaining to their job.
• Offers departmental project assistance as required and engages in process improvement and best practice activities.
• Performs additional duties as requested by the Business Operations Manager.
• Assist clinical staff with questions and problems related to charge capture.
• Escalates system issues to the support team as appropriate.

Organizational Expectations

Practices within the Medical Center's policies and procedures. Adheres to the Intensive Caring Value statements as demonstrated through positive patient/guest relations, positive and effective interactions with staff, and formulating and meeting developmental goals.

Complies with the AHIMA Code of Ethics and Standards of Ethical Coding. Complies with the Department of Medical Information Managements Standards of Conduct on Billing and Coding.

Minimum Qualifications:

For Hire:

• 2+ years of healthcare experience.
• Excellent verbal and written communication skills.
• Strong computer skills in areas of data mining and data analysis are desired.
• Minimum completion of a CAHIIM approved coding certificate program or HIMT program or equivalent education and experience.
• Demonstrated coding proficiency through satisfactory completion of OSUWMCs coding test.
• Familiarity or experience with computer assisted coding and/or automated encoder.

Required:

• Required for hospital coding: Credentialed as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) by the American Health Information Management Association.

Preferred:

• Minimum of two years of coding and charge reconciliation experience.

Competency expectations:

• Maintain continued education requirements as determined by the American Health Information Management Association or American Academy of Professional Coders. Review Coding Clinics, CPT assistant as frequently as needed for education purposes, and to ensure the official coding guidelines are followed.
• Attends coding meetings and coding education sessions for updates on coding guidelines and related issues while maintaining a minimum score of 90% on coding assessments quarterly.

Patient Population Served:

Knowledge of growth and development and an understanding of the range of treatments necessary to meet the age specific needs of the patient population served (Check those that apply):

Not Applicable: Non-patient care title

X

Adolescents (14 - 17 years)

Neonates (0 - 6 months)

Adults (18 - 64 years)

Children (7 months - 13 years)

Geriatrics (65 + years)

Job Relationships:

Supervisory Responsibility: None

Contacts: Personal contact with medical staff, faculty, vendors, the general public

Responsible to: Women and Infants Business Operation Manager

PHYSICAL/VISUAL/MENTAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing duties of this job, the employee must be able to:

• Transport/move materials in order to perform job functions.
• Move objects weighing up to 15 pounds.
• Use PC for long period of time.
• Constant use of computer keyboard.
• Perform necessary duties while working with office equipment.
• Able to respond to emergency situations and announcements.
• Sits in a normal seated position most of the workday.
• Communicate clearly.

WORK ENVIRONMENT

The work environment involves everyday risks or discomforts which requires normal safety precautions typical of such places as offices and meeting rooms (i.e., use of safe work practices, avoidance of trips and falls, and observance of fire regulations and traffic signs).

The Charge Entry Analyst and Coder qualifies for the Remote Work Program.

Note: The above statements are intended to describe the essential functions and related requirements of persons assigned to this job. They are not intended as an exhaustive list of all job duties, responsibilities, and requirements.