Coding Specialist - Medical Records (1.0 FTE, Days)

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Category: Medical Records
Job Type: Full-Time
Shift: Days
Location:  Menlo Park CA 94025
Req: 18431
FTE: 1

Medical Records

1.0 FTE, 8 Hour Day Shift

At Stanford Children’s Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Children's Hospital Stanford. And it's why we need caring, committed people on our team - like you. Join us on our mission to heal humanity, one child and family at a time.

Job Summary

This paragraph summarizes the general nature, level and purpose of the job.

The Coding Specialist is responsible for coding and abstracting inpatient records utilizing ICD-9 diagnosis and procedure codes, in accordance with coding conventions and guidelines. This requires thorough review of the medical record to validate assigned codes, assure optimum reimbursement and accurate abstraction of required data. Must be able to recognize when further documentation is necessary for accurate code assignment and appropriately query the physician (or others) for clarification.

Essential Functions

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. 

Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. 

Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).

  • Demonstrates a high degree of independence in performance of responsibilities, working effectively without direct supervision. Exhibits strong time management, problem solving and communication skills. Is able to effectively utilize various computer systems in performance of job functions.

  • Demonstrates an understanding of the revenue management cycle. Performs daily and weekly monitoring of unbilled/pending accounts and takes appropriate action in order to meet expected A/R goals.

  • Demonstrates competency in coding and abstracting all patient types in accordance with ICD-9 and CPT coding conventions and national coding guidelines, meeting the expected monthly quality and productivity standards according to departmental policy.

  • Maintains an understanding of regulations, standards and practices as they relate to Health Information Management. Is knowledgeable of the various regulatory and data reporting agencies and their functions.

  • Participates in continuing education opportunities and shows initiative in researching difficult or interesting subjects. Shares information with the rest of the team.

  • Understands importance of data reporting and interacts appropriately with physicians and other departments to obtain the documentation necessary for accurate code assignment.

  • Updates knowledge base annually in the following areas: ICD-9-CM, CPT-4 (valid and deleted codes), payment regulations for all payers types, coding conventions/rules as published in the Coding Clinic, and changes in medical terminology and advances in medical and surgical procedures.

Minimum Qualifications

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Education: High School diploma or GED equivalent

Experience: Two (2) years of progressively responsible and directly related work experience (for nonentry positions)

Licensure/Certification: Certified Coding Specialist (CCS)

Knowledge, Skills, and Abilities

These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.

  • Ability to adapt to changes and set priorities to meet tactical plans.

  • Ability to comply with the American Health Information Management Associate¿s Code of Ethic and Standards and applicable Uniform Hospital Discharge Data Set (UHDDS) standards.

  • Ability to establish and maintain effective working relationships.

  • Ability to manage, organize, prioritize, multi-task and adapt to changing priorities.

  • Ability to plan and organize work to meet deadlines.

  • Ability to solve technical and non-technical problems.

  • Ability to use computer to accomplish data input, manipulation and output.

  • Ability to utilize the ICD-9-CM & CPT-4 coding conventions to code medical record entries; abstract information from medical records; read medical record notes and reports; set accurate Diagnostic Related Groups.

  • Ability to work effectively through and with others.

  • Ability to speak, read, write, and understand English effectively at a level appropriate for the safe and effective performance of the job.

  • Knowledge of diagnosis/procedure DRG grouping schemes such as MS-DRGs and APR-DRGs.

  • Knowledge of health information systems for computer application to medical records.

Physical Requirements and Working Conditions
The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.

Pay Range

Compensation is based on the level and requirements of the role.

Salary within our ranges may also be determined by your education, experience, knowledge, skills, location, and abilities, as required by the role, as well as internal equity and alignment with market data.

Typically, new team members join at the minimum to mid salary range.

Minimum to Midpoint Range (1.0 FTE): $105,560.00 to $119,662.40

Equal Opportunity Employer

Lucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.