Senior Clinical Coder

The Mid Yorkshire Teaching NHS Trust; Wakefield; On-site; GBP 25,000 - 35,000; Full time

Job summary

A healthcare trust in Wakefield is seeking a Clinical Coder to join their Clinical Coding Department. The role involves extracting and coding clinical data accurately using established systems. The ideal candidate should have significant knowledge of clinical coding standards, a National Clinical Coding Qualification, and experience with Patient Administration Systems. Join us to make a difference by ensuring high-quality data management in patient care.

Benefits

NHS pension plan

Generous holiday allowance

Employee health and wellbeing services

Car lease and home electronics schemes

Qualifications

• Minimum A level qualification or equivalent knowledge required.
• National Clinical Coding Qualification necessary.
• Significant knowledge of clinical coding standards.

Responsibilities

• Screen medical records and extract clinical information.
• Code all patient episodes with M360 Solventum encoding system.
• Ensure accurate data entry into the Patient Administration System.

Skills

Significant knowledge of anatomy and physiology

Knowledge of clinical coding requirements

Understanding of confidentiality and Data Protection

Education

Minimum A level qualification or equivalent

National Clinical Coding Qualification

Tools

Patient Administration System (PAS)

Job description

The Clinical Coding Department is responsible for the accurate and timely recording of clinical data to support the Trusts clinical and business requirements and for regional and National Health Service statistics.

Our Trust recognises the vital contribution of our coding team to our overall Trust performance and regards our team as pivotal to our future performance.

The post holder will be required to work as a member of a team to provide an efficient clinical coding service working to established systems and procedures.

To screen medical records, discharge summaries and other data sources to extract clinical information relevant to a patients episode of care.

Through effective data extraction analyse complex clinical information; apply independent judgement in the interpretation, translation and sequencing of clinical data adhering to national rules and conventions.

To code all patient episodes using the M360 Solventum encoding system supported by International Classification of Diseases (ICD 10) and Office of the Population of Census and Surveys (OPCS 4) coding classifications.

Ensure data is entered accurately into the Patient Administration System within nationally/locally defined timescales.

Please refer to the attached job description and person specification for further details

Main duties of the job

• Screen medical records, discharge summaries, histopathology results and other data sources to extract clinical information relevant to a patients episode of care.
• Through effective data extraction analyse complex clinical information; apply independent judgement in the interpretation, transposition and sequencing of clinical data adhering to national rules and conventions.
• Code all patient episodes using the M360 Solventum encoding system supported by International Classification of Diseases (ICD 10) and Office of the Population of Censuses and Surveys (OPCS 4) coding classifications.
• Exercise initiative in selecting appropriate clinical terms to accurately reflect the individual patient record.
• Ensure data is entered accurately into the Patient Administration System (PAS) within national defined timescales.
• Regularly required to access and read patient case notes where the content can be distressing.
• Develop and maintain skills to use the PAS system and adhere to local coding protocols/procedures.
• Check patient details held on the system are correct e.g. consultant, date of admission and discharge reporting any incorrect details to the Data Quality Team.
• Routinely run outstanding episode reports from the Patient Administration System and action by searching for missing source documentation.
• Code complex specialties including mortality coding.

Please refer to the attached job description and person specification for further details

About us

We are an acute trust caring for over one million people in Wakefield and Kirklees. Our 10,000 staff members work in patients homes, the community, and our three hospitals in Pontefract, Dewsbury, and Pinderfields (Wakefield).Committed to continuous improvement, we prioritise our people and values so we can deliver excellent patient experience. Our team is friendly, passionate and always seeking better ways to work through research and innovation.We support work-life balance and foster a diverse, inclusive environment where everyone belongs. Our staff networks offer safe spaces for honest conversations and to share ideas, thoughts and concerns so we can increase awareness and appreciation of equality, diversity, and inclusion.As a member of the team, you will have access to the NHS pension plan, a generous holiday allowance, employee health and wellbeing services and extensive benefits and support. These include onsite nurseries, childcare vouchers, car lease and home electronics schemes, working carers support, carer-friendly policies, and more.If you value caring, high standards, improvement, and respect, join the MY team to make a difference every day.

Job responsibilities

Qualifications:

• Minimum A level qualification or equivalent qualification or equivalent knowledge.
• Undertaken the Clinical Coding Standards Course.
• Up to date with Clinical Coding Refresher Courses.
• National Clinical Coding Qualification.
• Successful completion of a coder audit.

Experience:

• The principles of Clinical Coding.
• Significant knowledge of anatomy and physiology and medical terminology.
• Significant knowledge of clinical coding requirements and standards.

Knowledge and Awareness:

• Knowledge of the importance of confidentiality, the Data Protection Act and Caldicott Principles.
• Thorough knowledge of Patient Administration Systems.
• Understanding of how acute hospital services function in relation to patient experience.
• Awareness of own limitations.

Please refer to the attached job description and person specification for further details.

Person Specification

Qualifications

• Please click 'apply now' to view the full person specification (there is no obligation to submit an application).

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.