Trauma Coder
Company: OhioHealth
Location: Columbus
Posted on: March 29, 2025
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Job Description:
We are more than a health system. We are a belief system. We
believe wellness and sickness are both part of a lifelong
partnership, and that everyone could use an expert guide. We work
hard, care deeply and reach further to help people uncover their
own power to be healthy. We inspire hope. We learn, grow, and
achieve more - in our careers and in our communities.Job
Description Summary:This position performs coding and abstracting
functions for Trauma Patients including Emergency Department,
Observation, Observation in a bed and the inpatient
setting.Responsibilities And Duties:60%
--- - - - - - - - - - - - Assigns appropriate admit, & principal
and secondary diagnoses and/or procedure codes by reading
documentation present in medical record and applying knowledge of
correct coding guidelines as appropriate for hospital service
and/or patient type while maintaining 95% quality and meeting and
maintaining the minimum Coder productivity requirements.
--- - - - - - - - - - - - Assign Present on Admission POA indicator
to all inpatient account diagnoses as required by official coding
guidelines.
--- - - - - - - - - - - - Accurately Assign ICD10
diagnosis/procedure codes, AIS scoring at the minimum standards of
95% quality and meeting and maintaining the minimum Coder
productivity requirements.
Review Diagnosis and CC/MCC for maximum SOI/ROM Clinical understand
of laboratory and radiology values Knowledge of quality outcomes
indicators Work with CDS to improve physician documentation and
case mix index Assign Principal Diagnosis accurately at least 95%
or better
--- - - - - - - - - - - - Monitor and appropriately assign codes
when appropriate
--- - - - - - - - - - - - Responsible for recognizing when it is
necessary to obtain further clarification from physician when
documentation is inadequate, ambiguous, or unclear for coding
purposes.
--- - - - - - - - - - - - Assists providers and supervisors with
reviewing accounts denied by NTDB and other governing bodies for
appropriate documentation to support original coding.
35%
--- - - - - - - - - - - - Abstracts all data elements necessary to
complete NTDB and TQIP requirements and meet hospital-reporting
requirements.
--- - - - - - - - - - - - In the event of insufficient, missing, or
conflicting documentation, follows department policy for follow up
and physician query.
--- - - - - - - - - - - - Identifies problem cases in EPIC and
forwards to appropriate staff for follow up.
5%
--- - - - - - - - - - - - Verifies demographics, account number,
service and identify missing or incorrect forms in each record.
The major duties, responsibilities and listed above are not
intended to be all-inclusive of the duties, responsibilities and to
be performed by employees in this job. Employee is expected to all
perform other duties as requested by supervisor.Minimum
Qualifications:Associate's DegreeCSTR - Certified Specialist in
Trauma Registries - Registrar Certifying Board of the American
Trauma SocietyAdditional Job Description:SPECIALIZED
KNOWLEDGESpecialized Knowledge: AIS Scoring, ICD-10CM and PCS
classification systems, Advanced Anatomy & Physiology,
Pathophysiology, Pharmacology, Medical Terminology, inpatient
documentation schemes. Knowledge of Hospital Acquired Conditions
(HAC), Present on Admission (POA), Severity of Illness (SOI), Risk
of Mortality (ROM), and Quality outcome indicators. - Knowledge of
operative reports, clinical lab, and radiology results for
physician queries. Knowledge of Clinical Documentation improvement
programs. Knowledge of NTDB and TQIP abstracting elements.Work
Shift:DayScheduled Weekly Hours :40DepartmentTrauma ServicesJoin
us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in
the healthcare industryEqual Employment OpportunityOhioHealth is an
equal opportunity employer and fully supports and maintains
compliance with all state, federal, and local regulations.
OhioHealth does not discriminate against associates or applicants
because of race, color, genetic information, religion, sex, sexual
orientation, gender identity or expression, age, ancestry, national
origin, veteran status, military status, pregnancy, disability,
marital status, familial status, or other characteristics protected
by law. Equal employment is extended to all person in all aspects
of the associate-employer relationship including recruitment,
hiring, training, promotion, transfer, compensation, discipline,
reduction in staff, termination, assignment of benefits, and any
other term or condition of employment -
Keywords: OhioHealth, Columbus , Trauma Coder, Other , Columbus, Ohio
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