Coding Specialist

Maimonides Medical Center Inc.; New York (NY); On-site; USD 113,728,000 - 147,403,000; Full time

Benefits offered by this job

Job summary

Maimonides Medical Center in Brooklyn seeks a detail-oriented medical coder to review medical records, confirm diagnoses, and assign ICD-10-CM, ICD-10-PCS and CPT-4 codes for billing. You will ensure documentation supports DRG assignments, abstract data for regulatory reporting, and adhere to AHIMA/AAPC guidelines with a focus on accuracy and compliance.

The role requires a coding certificate, strong terminology knowledge, and prior coding experience; a supportive team environment and ongoing

Qualifications

• High school graduate or equivalent.
• Coding certificate in ICD-10-CM/ICD-10-PCS/CPT-4 required and AHIMA/AAPC recognized.
• 1 year coding experience preferred; knowledge of medical terminology and coding concepts.

Responsibilities

• Examine medical records for accuracy and consistency; report discrepancies.
• Determine diagnoses and procedures to assign ICD-10-CM and ICD-10-PCS codes.
• Abstract data for DRG assignments and regulatory reporting.
• Enter data into hospital systems and support quality control.
• Participate in education and quality improvement initiatives.
• Maintain confidentiality and comply with safety and infection control standards.
• Assist in training and supervising staff; evaluate performance as needed.

Skills

Medical terminology

AHIMA/AAPC knowledge

Attention to detail

Data integrity

Confidentiality

Education

Coding certificate (AHIMA/AAPC recognized)

CCS/CCS-P/RHIT/RHIA preferred

Job description

About Us

We’re Maimonides Health, Brooklyn’s largest healthcare system, serving over 250,000 patients each year through the system’s 3 hospitals, 1800 physicians and healthcare professionals, more than 80 community-based practices and outpatient centers. At Maimonides Health, our core values H.E.A.R.T drives everything we do. We uphold and maintain Honesty, Empathy, Accountability, Respect, and Teamwork to empower our talented team, engage our respective communities and adhere to Planetree's philosophy of patient-centered care. The system is anchored by Maimonides Medical Center, one of the nation’s largest independent teaching hospitals and home to centers of excellence in numerous specialties; Maimonides Midwood Community Hospital (formerly New York Community Hospital), a 130-bed adult medical-surgical hospital; and Maimonides Children's Hospital, Brooklyn's only children's hospital and only pediatric trauma center. Maimonides' clinical programs rank among the best in the country for patient outcomes, including its Heart and Vascular Institute, Neuroscience Institute, Boneand Joint Center, and Cancer Center. Maimonides is an affiliate of Northwell Health and a major clinical training site for SUNY Downstate College of Medicine.

Overview

Data management functions in a variety of application areas; including clinical coding, outcomes

management, and specialty registries. Reviews medical records to confirm diagnoses and apply appropriate

disease and procedure codes in ICD-10- CM, ICD-10-PCS and CPT-4 classification systems.

Abstracts and analyses records for appropriateness of documentation for assigning DRG. Enters data into computer system to produce documentation required for correct patient billing. Assists in protecting legal interests of the patient, hospital and physician. Data Entry, and retrieval of data for the purpose of statistical reporting.

Responsibilities

• Examines the medical record for consistency and accuracy of identifying information; reports any discrepancies or problems to supervisor
• Reviews medical record to determine all diagnoses and procedures in order to assign the appropriate codes.
• Assigns and sequences ICD-10-CM diagnostic and ICD-10-PCS procedural coding on all cases and utilizes AHIMA coding guidelines
• Abstracts data required by federal and state regulatory agencies (e.g., physician information, patient demographics) and enters into hospital computer system
• Analyzes for optimization and DRG assignments utilizing Encoder
• Identifies documentation specifics to support the diagnoses; provides the supervisor with the information to be communicated to the physicians
• Carries out all quality control procedures required by the department to ensure the accuracy of data
• Meets the required daily coding (ICD-10) and competency levels established for inpatient medical records (14-16) records with error rate <5%)
• Meets required coding (ICD-10) and competency standards for Ambulatory Surgical records. (30-35) amb/sur records with error rate <8%)
• Meets the required daily coding (ICD-10) and competency levels established for inpatient medical records (14 records with error rate <5%). Amb/surg records with error rate <8%.
• Inserts tumor registry forms in record when required
• Competes DOH forms for appropriate records, i.e. Alzheimer’s and CMRResponsible for submitting DOH forms to the responsible person in a timely manner
• Assigns charts to appropriate review area for quality check
• Participates in the quality improvement process of the department and/or medical center
• Participates in the educational programs and in-service meetings to enhance skills and development as demonstrated by record of in-service/continuing education
• Maintains and enhances professional growth and development through educational programs, workshops, and professional affiliations
• Maintains established departmental pollicies and procedures, objectives, compliance program, confidentiality, safety, environmental, and infection control standards
• Assists in selecting, training, assigning, and monitoring staff; evaluates performance; and makes recommendations for personnel action

Qualifications

High School graduation or equivalent required.

Successful completion of a coding certificate program in ICD-10-CM, ICD-10-PCS, CPT-4 coding recognized by the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPC) required. CCS, CCS-P, RHIT, or RHIA preferred.

1-year prior coding experience preferred. Knowledge of medical terminology, disease processes, pharmacology, anatomy, physiology required; Knowledge of E&M, CPT, ICD-10, and HCPCS coding required; Knowledge of APCs and APGs required; Must pass basic coding test; Must pass basic data entry skills test; Good oral and written communication skills; Good interpersonal skills; Speaks, reads, and writes English to the extent required by the position; knowledge of a second language preferred.

Pay Range

USD $39.69 - USD $51.45 /Hr.

Equal Employment Opportunity Employer

Maimonides Medical Center (MMC) is an equal opportunity employer.