|Required Certifications:||CPC or CCS
Assign ICD-9 DX Codes, CPT / HCPCS codes and verifies charge posting information that determines Medicare, Medicaid and private insurance billing by abstracting pertinent data from multiple components of the patient record.
CORE FUNCTIONS AND COMPETENCIES:
Review the pathology report for abstracting and coding the diagnosis and evaluate CPT/HCPCS codes selecting the most accurate and descriptive code(s).
Analyze the report for substantiation of charges; identifies deficiencies and educates providers so providers can rectify the deficiencies.
Provides assistance to staff in retrieving and development of report data for audit review and charge substantiation.
Keeps abreast of pathology coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor, pathologist, section director or department administrator for resolution.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
Must maintain an in-depth knowledge of use of coding software and multiple information systems and an advanced understanding of medical terminology and body systems/anatomy and physiology and concepts of disease. Ability to adapt to new software programs.
Ability to elicit cooperation from and work in a cooperative manner with professionals and nonprofessionals associates.
Demonstrates commitment to our core values of excellence and innovation, integrity and respect, teamwork and communication.
Knows policies and procedures applicable to assigned duties. Uses sound judgment and is aware of potential hazards before taking action. Promptly reports errors/events or situations of actual or potential harm. Understands emergency procedures and can demonstrate appropriate response.
High School diploma or GED required.
CERTIFICATES, LICENSES, AND REGISTRATION:
Certified Coding Specialist (CCS), Certified Coding Specialist-Procedural (CCS-P), or Certified Professional Coder (CPC), certification.
May consider 5 years work experience as substitute for credentials; experience in coding and abstracting using ICD-9-CM, CPT-4, and HCPCS coding for pathology
Certification renewed annually
One year with direct experience in pathology professional coding including but not limited to NCCI edits as they relate to pathology
Completed work is relied upon for accuracy; constant change from changing 3rd party and HCFA reimbursement rules and regulations.
Jefferson Health delivers state of the art healthcare services to patients throughout the Delaware Valley and southern New Jersey. Jefferson (Philadelphia University + Thomas Jefferson University) provides more than 7,800 students from nearly 40 states and 40 countries with 21st century professional education. Combined, we have 30,000 employees.
Jefferson Health, with 14 hospitals (seven are Magnet designated by the ANCC for nursing excellence) and 40+ outpatient and urgent care locations, offers a broad range of primary and complex, highly specialized care that touches the lives of more than four million patients annually. U.S. News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in 10 specialties. Jefferson Health also includes the NCI designated Sidney Kimmel Cancer Center; it is one of only 70 such centers in the nation.
Jefferson (Philadelphia University + Thomas Jefferson University) has ten colleges and three schools that offer more than 160 undergraduate and graduate programs. Our University is dedicated to inter-professional and transdisciplinary approaches to learning that offer a vibrant and expandable platform for professional education. Through this unique model, we are preparing our students for current and yet to be imagined careers.
As an employer, the Jefferson Enterprise maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.