Job Description
2.1 Ensures proper coding of documents in accordance with the regulator’ coding guidelines and regulations
Responsibilities
- The incumbent checks and sequences the most accurate ICD-9 / ICD-10-CM / CPT / HCPCS / DRG / other codes for diagnoses and procedures based on documented information. Assures the final diagnoses and operative procedures as stated by the physician are valid and complete.
- Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions.
- Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Computes and assigns the correct DRG coding for all inpatient cases.
- Provides training and guidance to other coders / Medical Records Technicians, updating them with new coding rules and regulations as required.
- Analyzes doctors’ documentation to ensure appropriate Evaluation and Management (E&M) levels are assigned using the correct CPT codes.
- Ensures coding is as per HAAD guidelines and regulations.
- Provides feedback to doctors regarding coding errors or oversights.
- Keeps updated with the latest coding versions and HAAD coding directives.
- Performs miscellaneous job-related duties as assigned.
- Performs any other duties assigned by the HOD from time to time within the scope of the job title.
- Complies with all OSH and infection control policies, standards, and procedures, and cooperates with hospital management to meet these requirements.
- Works in accordance with the documented OSH procedures and instructions and fulfills specific responsibilities.
- Is familiar with emergency and evacuation procedures.
- Notifies OSH hazards, incidents, near misses, and issues, and assists with the preparation of risk assessments and incident reports.
- Complies with waste management procedures and policies.
- Attends applicable OSH / infection control training programs, mock drills, and awareness programs.
- Uses appropriate personal protective equipment and safety systems.
Qualifications
- A graduate with a Bachelor’s degree in Allied Health Sciences or a related field, with at least two (2) years of coding experience and a valid Certified Coding Associate (CCA) certification from AHIMA or Certified Professional Coder (CPC) certification from AAPC.
- Computer literacy, including MS Office.
- Excellent command of oral and written English.
Performance Criteria:
- Achievement of core objectives in line with the expectations of management and stakeholders.
- Ability to work constructively and interact professionally with others.
- Ability to coordinate multiple tasks, adapt to changing priorities, and work within deadlines.