Lafayette General Health
The Unbilled Coordinator plays a key role in LGMCs revenue cycle management process by monitoring and working unbilled accounts that are past the established coding/billing goal. The Unbilled Report will be used to determine which accounts are beyond the established coding target. The Unbilled Coordinator facilitates the flow of missing medical record documentation to the Coders so charts can be coded timely. Daily/weekly notifications are made to departments/individuals to retrieve needed documentation for coding purposes. The Unbilled Coordinator serves as a liaison to the Patient Financial Services Department, Patient Access, Ancillary Departments and all clinical departments within the facility.
1. Creates daily reports and works these reports to ensure documentation required is received for proper coding.
2. Demonstrates proficiency in Windows software to effectively create reports and communication documentation requirements to physicians, physician practices and ancillary departments for accurate and timely coding.
3. Determines validity of data and implements changes in the MPI (combines) when necessary.
4. Demonstrates attention to detail, strong motivation to validate data, thorough understanding of demographic information and chart processes as contained in various hospital information system databases.
5. Functions as a liaison to the Patient Financial Services Department, Patient Access, Ancillary Departments and all clinical departments within the facility as appropriate to this positions scope of responsibility to resolve issues as they relate to the unbilled process.
6. Communicates with the Manager of HIM and/or the Director of HIM with concerns/problems that are holding up coding beyond LGMCs established targets.
7. Manages the unbilled at or below target levels in an efficient, effective and professional manner.
8. Obtains dictated and ancillary reports, verifies that essential information is accurate and forwards the account to the responsible coder for coding to take place.
9. Informs the Manager of HIM about physician specific documentation deficiencies two to three times per week.
10. Attends all necessary unbilled meetings and telephone conferences upon request of the Manager of HIM and/or Director of HIM.
11. Maintains a clean working environment.
12. Adheres to the general hospital standards to promote a cooperative work environment by utilizing communication skills, interpersonal relationships, and team building.
13. Works with hospital teams to reach goals and objectives of the program, which include quality, safety, data integrity and accurate reimbursement.
14. Communicates information effectively.
15. Demonstrates responsibility for personal development by participating in continuing education offerings:
-Attends continuing education offerings
-Maintains competence related to DRG assignment, documentation requirements, and coding guidelines
-Participates in continuing education planning and preparation for other staff members
16. Keeps daily production of number of cases reviewed and the number of cases successfully routed to the Coders for weekly evaluation of productivity and results achieved.
17. Produces reports as requested and produces a monthly and quarterly summary report of cases reviewed and results achieved.
18. Maintains established hospital and departmental policies and procedures, objectives, performance, safety, environmental, and infection control standards. Maintains confidentiality and security levels to protect medical/legal patient care documentation.
19. Performs other duties as assigned.
- Required: A minimum of 1 year coding experience using the ICD-10-CM and CPT-4 coding system.
- Preferred: Graduate from an approved Health Information Management Program with credentials of Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or other coding credential.
- Knowledge of Diagnostic Related Groups (DRGs) is required.
- Experience in abstracting requested but not required.
- Working knowledge of The Joint Commission and OIG guidelines preferred.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
Medium Work as defined by the U.S. Department of Labor constitutes a maximum lift of 21-50 pounds on occasion and/or a maximum lift of 11-25 pounds on a frequent basis
May be required to assist in the turning, lifting, or moving patients as well as walking about from patients rooms, as well as to and from various hospital areas
Formal application; verification of education, and experience; verification of license(s), certification(s), registration(s), accreditation(s) if applicable; oral interview, reference and background checks; job related tests may be required.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must comply with all SERVICE Standards of Behavior