MetroWest Medical Center is the largest community health care system between Worcester and Boston. MetroWest Medical Center is committed to providing high quality, comprehensive care, at a location close to home. The 307-bed regional healthcare system includes Framingham Union Hospital, Leonard Morse Hospital in Natick and the MetroWest Wellness Center. In 2018, MetroWest Medical Center achieved the Healthgrades Americaï¿½s 100 Best Hospitals Awardï¿½. This distinction makes MetroWest Medical Center one of the top 2% of more than 4,500 hospitals assessed nationwide for its consistent, year-over-year superior clinical performance as measured by Healthgrades, a leading online resource for comprehensive information about physicians and hospitals.
GENERAL SUMMARY: Under the general supervision of the HIS Coordinator for Data Quality (Coding Manager) and according to established policies and procedures, assigns ICD9-CM and CPT-4 codes to medical record information. Determines appropriate DRG, AP-DRG, ASC, APG assignment for optimal reimbursement. Abstracts required data into the Medical Center's computerized data base. The outcome of information gathered is used to determine Medical Center statistics, casemix, and reimbursement of Hospital claims.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
1. Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures. Assigns proper ICD-9-CM and CPT-4 diagnostic and operative procedure codes to inpatient, TCU, surgical day care, observation, emergency, and selected outpatient records by reference to computerized/written coding aids and other reference material. Consults with the appropriate physician to clarify medical record information.
2. Assigns grouper codes to each record according to patient type and financial class (AP-DRG,HCFA-DRG, ASC, APG). Enters coded/abstracted information in grouper, analyzes groupings, and assigns the appropriate grouper for optimal reimbursement. Data enters abstracted demographic/clinical information into the Medical Center's computerized abstracting database.
3. Prepares and prints coding summaries for each required case by entering the appropriate casemix data. Notifies physicians that statements are needed for signature as necessary; follows up on their return in a timely manner.
4. Works with Patient Accounts and Admitting on problem accounts. Answers physician/clinician questions regarding coding principles, DRG assignment, and prospective payment systems groupers and optimization. Assists Finance, Information Systems, and other departments with coding/DRG issues.
5. Monitors and retrieves missing records to close the month. Works the unbilled report for missing diagnoses. Performs clerical functions specific to each hospital. Assists with record processing and main office backup as needed.
KNOWLEDGE, EXPERIENCE AND OTHER JOB REQUIREMENTS:
1. Level of knowledge equivalent to that ordinarily acquired through completion of an Associate's Degree in medical record technology.
2. Six to twelve months of inpatient ICD-9-CM coding experience in an acute care facility.
3. Eligible for designation as an ART, RRA or CCS.
Job: Medical Coding
Primary Location: Natick, Massachusetts
Facility: MetroWest Leonard Morse Hospital
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1805005757
About MetroWest Leonard Morse Hospital
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.