Medical Records Coder II - Duke Homecare and Hospice - PRN

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke HomeCare & Hospice

Pursue your passion for caring with Duke HomeCare & Hospice, which offers hospice, home health, and infusion services across the region, as well as serves as the home forthe Duke Caregiver Support Program. Team members work closely with a patient's physician to provide comprehensive, individualized care in the comfort of their home or at our inpatient hospice facility in Durham, NC.

Must Reside within 2 Hours of Office

Please note: All Duke medical coding opportunities require candidates to have a North Carolina address as a condition of employment.

Job Summary

The Duke HomeCare &Hospice Medical Records Coder II is a certified Coder, responsible for coding activities for the home health and hospice areas at Duke. Code medical records utilizing ICD-10-CM coding conventions. Review the medical record to ensure specificity of diagnoses and appropriate/optimal reimbursement for Home Health and/or Hospice. Abstract information from medical records following established methods and procedures.

Job Responsibilities 

• Review the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM coding conventions
• Review medical record documentation and accurately code the primary/secondary diagnoses using ICD-10-CM coding conventions.
• Sequence diagnoses using coding guidelines.
• Abstract and compile data from medical records for appropriate optimal reimbursement for Home Health or Hospice and/or professional charges.
• Consult with and educate physicians on coding practices and conventions to provide detailed coding information.
• Communicate with nursing and ancillary services personnel for needed documentation for accurate coding.
• Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM coding guidelines to inpatient and outpatient diagnoses and procedures.
• Maintain a thorough understanding of medical record practices, standards, regulations, The Joint Commission, Health Care/Finance Administration (HCFA), Medical Review of North Carolina (MRNC), DHHS (Department of Health and Human Service), etc.
• Assist with special projects as required.
• Perform other related duties as assigned.

Education and Formal Training

High School Diploma required

Experience

• RHIA certification- no experience required
• RHIT certification- no experience required
• CCS certification- one year of coding experience required
• CPC or HCS-D certification- two years of coding experience required

Degrees, Licensure, and/or Certification

• Must hold one of the following active/current certifications:
• Registered Health Information Administrator (RHIA) Hospital Coding
• Registered Health Information Technician (RHIT) Hospital Coding
• Certified Coding Specialist (CCS) Hospital Coding
• Certified Professional Coder (CPC)
• Homecare Coding Specialist-Diagnosis (HCS-D) Homecare Coding

Knowledge, Skills & Abilities

• Advanced ICD-10-CM & CPT-4 coding conventions 
• Anatomy and Physiology 
• Medical Terminology 
• Extensive DRG/APC reimbursement knowledge 
• HH PDGM Knowledge R/T Coding
• Coding software familiarity 
• Effective written and verbal communication skills 
• Data entry/CRT