It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

GENERAL SUMMARY:

Under the general direction of the Coding Manager, reviews the medical record to verify diagnoses and procedures. Codes the record by using the appropriate coding classification system. Verifies codes for statistical and reimbursement purpose.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Performs review of clinic documentation. Verifies diagnosis as assigned by physicians on the encounter form and assigns appropriate ICD-10 CM diagnosis.
• Conduct coding, as well as interact with division management personnel to maximize individual and departmental revenues. Code (CPT and ICD-10 CM) and data entry all operative procedures using operative reports, consultations, daily hospital care, special procedures and office visits with 95% accuracy rate.
• Verifies procedures documented on encounter forms and validates that the clinic note reflects assigned procedures, making changes as needed in consultation with the physician.
• Assigns the correct level of E&M code utilizing CPT Guidelines.
• Assigns appropriate Level I/Level II Modifiers to procedures in order to expedite and maximize reimbursement.
• Performs related duties such as answering and routing telephone calls and receiving people requesting action or follow up to the designated patient account representative.
• Participation in continuing education programs as requested by Management
• Participate in department staff training programs to develop skills that will achieve business goals and foster individual career growth.
• Performs or assists with other duties assigned by the Coding Manager.
• Trains clinic staff on the use of ICD-10CM/CPT-4 codes.
• Reconciles daily reports and provides weekly feedback to Department and Clinic Management
• Performs other similar and related duties as required or directed.

JOB KNOWLEDGE AND SKILLS:

• Working knowledge of ICD-10-CM/CPT-4 coding systems, medical terminology, anatomy and physiology.
• Excellent organizational and communication skills.
• Ability to work independently.

EDUCATION:

• Completion of a coding certificate program required.

EXPERIENCE:

• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

LICENSES, ETC.:

• RHIT/RHIA or CCS required.

AGE SPECIFIC COMPETENCIES:

Possesses and applies the skills and knowledge necessary to provide care to patients throughout the life span, with consideration of aging processes, human development stages and cultural patterns in each step of the care process. This includes:

• Knowledge of growth and development
• Ability to interpret age specific data and response to care
• Provide age specific communication

WORKING CONDITIONS/PHYSICAL DEMANDS:

• General office environment.
• Frequent use of a computer terminal.
• Frequent contact with physicians, nursing, administration, finance, and outside audit personnel.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.