Senior Coder - Specialty Surgeries

100 LCMC Health; Louisiana (MO); Hybrid; USD 40,000 - 55,000; Full time

Job summary

100 LCMC Health is looking for a coding specialist in Louisiana responsible for accurately determining diagnosis and procedure codes. The ideal candidate will have experience navigating health records and communicating with clinical staff.

A high school diploma (or equivalent) and at least 3 years of experience in coding are required, with additional certifications preferred. This role ensures timely coding and adherence to regulations in a supportive environment.

Qualifications

• Minimum 3 years work experience or equivalent education.
• Certification in coding preferred.
• Experience with ICD-10-CM/PCS coding and training.

Responsibilities

• Navigate patient health records to determine coding.
• Communicate with clinical staff about documentation needs.
• Track issues for timely coding.

Skills

Comprehensive working knowledge of medical terminology

Knowledge of third-party reimbursement regulations

Ability to use standard desktop and Windows-based computer systems

Strong analytical abilities

Excellent oral and written communication skills

Education

High School Diploma/GED or equivalent

Associate's Degree in HIM or similar

Diploma/Certification in Coding

Tools

Encoding/grouping software

Job description

Specialties

ENT/General Surgery/Plastic Surgery/Dermatology

General Duties

• Proficiently navigate patient health records and other computer systems/sources to accurately determine diagnosis and procedure codes, MS-DRGs and APCs assignment and all required modifiers.
• Validate charges by comparing charges with health record documentation as necessary.
• Communicate effectively with clinical staff, physicians, office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
• Identify concerns and notify appropriate leadership for resolution.
• Provide resolution to moderate to complex problems.
• Track issues (i.e., missing documentation, charges and physician queries) that require follow‑up to facilitate coding in a timely fashion.
• Consistently meet or exceed coding quality and productivity standards established by the coding department.
• Adhere to LCMC confidentiality requirements as they relate to release of any individual or aggregate patient information.
• Maintain up‑to‑date knowledge of changes in coding and reimbursement guidelines and regulations.
• Perform other duties as assigned by leadership.
• Maintain working knowledge of applicable coding and reimbursement federal, state and local laws and regulations, the Code of Ethics, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Education / Experience Qualifications

• Required: High School Diploma/GED or equivalent and 3 years of work experience;
  or Associate’s and 1 year of experience;
  or Diploma/Certification in Coding and 1 year of experience.
• Preferred: Associate's Degree in HIM or similar; Completion of AHIMA Approved coding program or AAPC coding program.

Licenses and Certifications

• Certification in the following areas is also preferred: Registered Health Information Technician from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA;
  Registered Health Information Administrator from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA;
  Certified Coding Specialist from the Commission on Certification for Health Informatics and Information Management (CCHIIM)- AHIMA.

Knowledge, Skills, and Abilities

• Comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping and components of charge description master for charging functions.
• Knowledge of third‑party reimbursement regulations and billing practices; experience utilizing encoding/grouping software.
• Ability to use standard desktop and Windows‑based computer system, including basic understanding of email, internet, and computer navigation.
• High ethical standards.
• Knowledge of ICD‑10‑CM, ICD‑10‑PCS, CPT/HCPCS, MS‑DRG, APR‑DRG and APC coding principles and guidelines.
• Experience in ICD‑10‑CM/PCS coding and reimbursement training.
• Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider‑based clinic encounters.
• Knowledge of hospital and professional coding including provider‑based billing.
• Knowledge of documentation regulations of Joint Commission and CMS.
• Experience with concurrent coding reviews.
• Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices.
• Experience in assisting and identifying learning needs as well as providing training to coding staff.
• Strong analytical abilities and problem‑solving skills.
• Excellent oral, written and interpersonal communication skills.
• Ability to organize and set priorities to ensure objectives are met in a timely manner.
• Ability to adapt to change and handle challenges proactively and with poise.
• Ability to effectively collaborate with physicians and managerial staff at all levels.

Work Shift

Variable Hours (United States of America)

Equal Opportunity Employer

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

Job Summary Disclaimer

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.