Medical Coder

Job Code

30000956

Basic Function

Medical Coders is responsible to generate coded information. This process is conducted through the review of the clinical information and translating it to codes utilizing the International Classification of Diseases code set (ICD-10-AM), the Australian Classification of Health Interventions, (ACHI) code set. Coder also responsible to calculate the Diagnosis Related Group (DRG) code and abstracts detailed patient information for each episode of care. Medical Coder provides classified data for patient population health, health information exchange, physician performance and utilization review, insurance, planning and forecasting for health care services.
 

Scope

Medical Coder requires experience in the ICD-10-AM/ACHI coding classifications. Medical coding is the foundation of the revenue cycle management process, therefore, the medical coder is required to produce accurate coding to insure optimum revenue. In addition to that, utilization of coded data for healthcare planning. Also, provide statistical data such as population health, coding diagnoses and procedures allowing health care providers to conduct clinical research, identify health care trends, comorbidities and complications for disease management and prevention planning

Principal Contacts

Daily contact with medical coding team lead, coding auditors and coding team. Contact with healthcare professionals and support staff within JHAH
 

Principal Duties

1. Assigns codes for in-patient, out-patient and emergency encounter using the International Classification of Diseases (ICD-10-AM) guidelines and the Australian Classification of Health Interventions (ACHI) guidelines.
2. Abstracts detailed procedure information for each episode of care to associate ACHI codes with provider and  date and time of the procedure
3. Query physicians to clarify imprecise documentation to arrive at the appropriate ICD-10-AM code and ensure the accurate DRG.
4. follow up  with physicians to resolve queries and communicate documentation requirements for coding 
5. Cooperate with document analysis team to resolve any encounter’s problem that needs their attention
6. Provide orientation and training for new hires and trainees and oversees and review their coding accuracy
7. May be assigned as coding team auditor utilizing the electronic audit program (3M Auditor)
8. Provide feedback to the medical coders based on audit summary along with recommendations.
9. Provide/conduct in-service education sessions for the clinical coders based on the auditing results
10. Share a quarterly quality report with the coding team lead and present the results
11. Keep up to date with the annual international coding updates and ensure the team’s awareness.
12. Communicate with JHAH interface team and 3M to report issues and update 3M HDM.
13. Provide legacy reports to support related stakeholders from 3M for forecasting and planning purposes.
14. Generate IT tickets to address any IT issues.
15. Validating and auditing statistical reports to ensure the quality of the coded and abstracted health information.
16. Report inaccuracy that might result in impacting the patients negatively to team lead.
17. Participates in reviewing and updating policies and procedures within the organization.
18. May be assigned as a coding auditor
19. Adheres to policies and procedures when conducting activities.
20. Treats customers (guests, patients, physicians, and other employees) with courtesy and respect. Responds quickly and appropriately to customer requests. Anticipates customer needs and initiates action to meet those needs.
21. Participate in team/division/departmental meetings and safety programs.
22. Participate in an appropriate in-services and educational opportunities.
23. Follow up with coding auditor and make any necessary  corrections
24. Meet and/or exceeds the established coding accuracy metrics while meeting and/or exceeding productivity standards.
25. Completes other tasks as assigned by team lead

Education

Bachelor’s Degree in Health Information Management or equivalent

Experience

• Minimum 5 years’ experience in healthcare information setting, preferably in coding.
• Requires knowledge of ICD-10-AM guidelines, ACHI and DRGs, medical terminology and anatomy and physiology
• Requires comprehensive understanding of clinical documentation standards related to clinical coding.
   

Certifications/Other requirements as applicable

Certifications:

• Valid registration of Saudi Commission for Health Specialties.

Language:

• Excellent verbal and written English with accurate grammar and composition. 
• Excellent knowledge of medical terminology, anatomy, physiology and procedures.

Skills:

• Excellent computer skills.
• Excellent communication skills in dealing with the healthcare professionals and support staff within JHAH. 
• Analytical ability to allow for interpretation of clinical data for coding in all clinical specialties.
• Analytical ability to interpret statistical data for reporting purposes.

Other

• Willing to work shift pattern as required (day, evening, night).
• Willing to work overtime if needed.