Job Title:Quality Coding/Documentation Educator II
Location: State College and Philipsburg(time spent at both)
Department:Geisinger Health Plan, Actuarial Services
Work Type: Full Time
Schedule options available (upon successful completion of training):
Four 10-hour shifts on site or Five 8-hour shifts with four days on-site and one-day at home option
Working with minimal supervision, the CPSL Coder II, provides training and process improvement efforts across the clinical practices for the development of consistent and comprehensive clinical practices supported by the Geisinger Health Plan. With thorough working knowledge of clinical practice management and thorough data analysis, identifies process improvement opportunities associated with the management of risk adjustment initiatives. Investigates current processes, assessing efficiency and accuracy and provides solutions for problems, process improvement, development of training programs, and documentation strategies that support ICD-10 complex terminology for clinical practice operations and management. Serves as a liaison between Clinical Operations and the Risk and Revenue Management team and facilitates communication between various constituents in order to assist in capturing chronic disease burden of the clinical enterprise patient population
Competencies and Skills:
Demonstrates competency in the use of computer applications, IDX, software related Medicare edits, and all coding and abstracting software/hardware currently in use by Hospital and Professional Coding Operations.
Demonstrates updated skills required for the ICD-10-CM and ICD-10-PCS coding system
Demonstrates advanced skills in extracting and analyzing clinical documentation.
Demonstrates superior knowledge of anatomy and physiology along with disease pathophysiology.
Demonstrates knowledge in the encoder software and the EMR (EPIC) and uses these tools along with their knowledge in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and chronic conditions to be coded.
Thorough understanding and application of new and expanded coding guidelines for both ICD-10-CM and ICD-10-PCS.
Demonstrates accurate understanding of procedural codes in the complex ICD-10-PCS code set.
Demonstrates excellent interpersonal skills to develop relationships necessary to influence physician documentation process.
Demonstrates analytic skills necessary to clinically assess medical records.
Demonstrates excellent prioritization and organizational skills.
Demonstrates proven analytical ability.
Demonstrates ability to work with minimal supervision at a high level of accuracy and productivity.
Demonstrates ability to communicate both verbally and in writing in a highly professional manner.
Demonstrates ability to be punctual and maintain an excellent attendance record
Demonstrates ability to be articulate, mature, and highly organized.
Demonstrates ability have close attention to detail viewing a computer monitor, reading reports in electronic format, and reading physician handwriting.
Demonstrates ability to meet deadlines and function under pressure.
Demonstrates strict confidentiality of financial and medical records.
Ability to maintain a minimum 95% accuracy rate in professional coding while maintaining or exceeding established productivity benchmarks.
Education / Experience:
High School Diploma or GED required.
Minimum of three years coding experience in an acute care hospital or outpatient clinic setting required.
College level course work in coding to include ICD-10, CPT 4, medical terminology, human anatomy and physiology and minimum two years coding experience in an acute care hospital or outpatient clinic setting required.
Prior experience with and/or use of an encoder preferred.
Requires one of the following credentials CPC, COC, CIC, CCA, CCS, CCS-P, RHIT, RHIA
If suitable candidate cannot be found, applicants who meet basic qualifications and experience for a lower level position will be considered for hire at a lower level.Salary would commensurate with education/experience.
Working Conditions/Physical Demands:
Work is typically performed in an office environment. Travel may be required.
Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
Geisinger Health Plan (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.
About Geisinger: Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
Internal Number: 66404
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.