Coder Analyst

Analyzes the medical records to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT codes. Confirms appropriate DRG assignment. Communicates with physicians for clarification of documentation for coding. Abstracts and enters data from the medical records in order to maintain a database for statistics and reporting. Assists the Business Office in timely billing of patient information.

Responsibilities

• Reviews medical records to determine the ICD-10 CM, ICD-10 PCS and CPT codes to be utilized, in accordance with coding and reimbursement guidelines.

• Verifies data in the medical record abstract and accurately abstracts and enters clinical information from the medical records, to ensure the integrity of the database.

• Appropriately utilizes current UHDDS standards in the proper selection and assignment of the principal diagnosis, principal procedure, complications and cormorbid conditions.

• Reviews unbilled accounts reports daily and makes necessary adjustments to ensure all records are coded in a timely manner.

• Reviews case mix reports on a weekly basis and follow-up on any record requiring re-review.

• Participates in coding and abstracting quality reviews as required.

• Assists physicians and clarifies coding versus clinical issues.

• Assists other coders with coding questions to ascertain the most appropriate codes for billing and statistical information; refers coding questions to the Unit Leader, as necessary.

• Contacts physicians for clarification when necessary.

• Completes interim billing on rehabilitation and transitional care unit patients as requested by the Business Office.

• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.

• Performs other duties as assigned.

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to an Associate’s degree. Preference may be given to individuals possessing a Bachelor’s degree in a directly-related field from an accredited college or university.

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times.