What are the responsibilities and job description for the Coder position at City of Hope Careers?
About City of Hope
City of Hope is an independent biomedical research and treatment organization for cancer, diabetes and other life-threatening diseases.
Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope™, a subsidiary launched in 2019 serves employers and their health care partners by providing access to City of Hope’s specialized cancer expertise.
A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.
City of Hope’s commitment to Diversity, Equity and Inclusion
We believe diversity, equity and inclusion is key in serving our mission to provide compassionate patient care, drive innovative discovery, and advance vital education focused on eliminating cancer and diabetes in all of our communities. Our commitment to Diversity, Equity and Inclusion ensures we bring the full range of skills, perspectives, cultural backgrounds and experiences to our work -- and that our teams align with the people we serve in order to build trust and understanding. We are dedicated to fostering a community that embraces diversity - in ideas, backgrounds and perspectives; this is reflected in our work and represented in our people.
Position Summary
Under the supervision of the Coding Manager, Coding Supervisor, and Lead Coder, the Coder is responsible for following established procedures for the review, classification, and abstraction of clinical data from patients’ medical records regarding diseases, treatment given, and operative procedures for assignment of diagnostic and procedural codes and modifiers. This role abstracts and codes relevant data elements for a certain type of professional fee service area (i.e., Evaluation & Management, major and minor surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges) for multi-specialty physicians.
Key Responsibilities include:
- Reads and interprets medical record documentation to identify all diagnosis, conditions, problems and procedures for Evaluation & Management, surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges.
- Clarifies conflicting, ambiguous, or non- specific information appearing in a medical record by consulting the appropriate physician.
- Applies Official ICD-10-CM Guidelines to select first-listed diagnosis, primary procedure, complications, co-morbid conditions, other diagnoses and significant procedures which require coding.
- Applies knowledge of ICD-10-CM and CPT-4 instructional notations and conventions to locate and assign the correct diagnostic and procedural codes and sequence them correctly.
- Applies knowledge of current approved ICD-10-CM and CPT-4 coding guidelines to assign and sequence the correct diagnoses and procedure codes.
- Applies knowledge of anatomy, clinical disease processes, and diagnostic and procedural terminology to assign accurate codes to diagnoses and procedures.
- Applies the Basic Coding Guidelines for professional fee physician coding to select and sequence diagnoses, conditions, problems, or other reasons which require coding for professional fee charges.
- Applies knowledge of CPT-4 coding guidelines and notes to locate the correct codes for all services and procedures performed during the encounter and sequence them correctly.
- Applies knowledge of government and commercial payer reimbursement guidelines to ensure optimal reimbursement.
- Ability to utilize computerized encoder/grouper as a reference tool for coding.
- Keeps current with ICD-10-CM and CPT-4 code changes, coding guidelines, and coding updates.
- Assist with charge corrections as identified when coding professional fee services.
- Reviews and completes required reporting documents as required by external and internal systems.
- Completes productivity reports and submits them to the manager, supervisor, or lead.
- Consistently meets coding quality standards and thresholds.
- Attends meetings as required.
- Successfully completes required education courses to maintain current coding certification.
Basic education, experience and skills required for consideration:
- Post High School or equivalent.
- Two years of coding experience of professional fees (physician/medical office).
Required Courses/Training:
- Thorough knowledge of medical terminology/anatomy/ physiology.
- Comprehensive understanding of professional fee coding principles, including knowledge and proper application of assigning ICD and CPT codes, bundling, and modifiers based on regulatory guidelines.
- Current knowledge, training and experience in ICD-10.
Required Courses/Training:
- CPC, CCS-P, or CCS
Additional Information:
- As a condition of employment, City of Hope requires staff to comply with all state and federal vaccination mandates.
- This position is represented by a collective bargaining agreement.
City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.