Job Detail

Join the UHS Southern CA Regional Office team!

The UHS Southern CA Region consists of five acute care facilities located in the Southern CA area;

• Temecula Valley Hosptial in Temecula, CA
• Southwest Healthcare System: Inland Valley Medical Center in Wildomar, CA and Rancho Springs Medical Center in Murrieta, CA
• Corona Regional Medical Center in Corona, CA
• Palmdale Regional Medical Center in Palmdale, CA

The Lead Coder collaborates with staff across the Region and is responsible for working closely with the Health Information Management (HIM) staff to ensure accurate charging and coding. Coordinates review and audit of accounts with accordance to established Coding rules and regulations. Assists HIM Management with new hire orientation, staff training and managing accounts to ensure timely resolution of coding issues for all record types.

POSITION SPECIFIC RESPONSIBILITIES:

• Revenue Cycle Support
  • Maintains a working knowledge of various payment methodologies (MS-DRG, APC), HCPCS, ICD-10, CPT, and CMS coding requirements.
  • Works closely with the Central Business Office (CBO) to make certain that problem accounts are addressed timely; Communicates with CBO in regards to pended claims and medical review statuses.
  • Performs interim coding when required.
  • Participates in unbilled calls and assists with Coding related issues, as appropriate.
  • Works with Case Management departments of all facilities to ensure accurate service types, maintaining appropriate charge capture for all requested changes.
  • Works with Regional Coding Manager to track and trend coding productivity to ensure coding is completed within the expected timeframe (4 days inpatient;5 days outpatient).
• Training / Education / Coding Compliance
  • Assists HIM management with orientation and systems onboarding.
  • Provides training and follow-up to Coders as needed.
  • Supports research for questions regarding new codes for diagnoses or procedures as needed.
  • Assists in quarterly audits for all facilities; attends exit conferences and works with coders in making necessary corrections in a timely manner; Ability to successfully perform coding quality reviews to validate correct coding for coders.
  • Participates in and contributes to educational calls.
  • Coordinates and oversees review of HAC, HAI, PSI and DRG mismatch accounts as necessary.
  • Contributes to Coder annual evaluations.
  • Reviews RTIFF reports daily to ensure that all holding accounts are cleared timely.
  • Stays abreast of current developments in Coding and informs coders of new changes (including trends, developments, state, local and federal laws).
  • Educates and assists coders and physicians in the query process; ensuring queries are addressed in a timely manner.
  • Serves as an educator for the coders and others in the application of coding guidelines and proper documentation requirements for correct reimbursement.
  • Has read, understood, and abides at all times by the Coders’ Code of Ethics (Refer to AHIMA.org)
  • When charging/coding corrections are made after the account is billed, ensures that the revised charges/codes have been updated in the patient accounts system (3M HDM, Invision, PTIQ/PADX).
  • Accepts responsibility to read current periodicals and reference materials received through the HIM department and through UHS Corporate directives. Applies this knowledge to daily work to minimize errors.
  • Independently researches coding and abstracting issues before requesting information from other coders or managers.
  • Understands the appropriate documentation requirements for the medical record in order to meet Federal, State, and facility regulations. Reports documentation irregularities to the HIM Operations Manager and/or designee.
  • Maintains any license in a current status by keeping up-to-date on required education.
• Medical Staff
  • Queries physicians appropriately according to coding compliance guidelines, UHS, and HIM department guidelines.
  • Refers problem records/coding queries to a Clinical Documentation Improvement Specialist for review with possible follow-up with HIM Coding Manager, as appropriate.
• Organizational Responsibility
  • Works with fellow employees inside and outside the HIM Department to ensure timely and accurate charging and coding.
  • Works with the Clerical HIM staff to ensure a smooth workflow process to meet the requirements of UHS Corporate HIM Monthly Operations Report and all other HIM Department goals.
  • As assigned, demonstrates the ability to code records in alignment with the accuracy and productivity standards for those services coded supporting medical necessity, according to current ICD-10, CPT, HCPCS and UHDDS Coding guidelines, Coding Clinic and State/Federal regulatory guidelines.
  • Assists patients, physicians, insurance companies, etc… with coding issues and helps to coordinate the resolution.
  • Participates in specified taskforces, committees, or projects at the request of the HIM Management in order to maintain good interdepartmental communication for the purpose of coding and billing compliance.
  • Reviews all OSHPD Edits and/or Flags to ensure clean data submission to meet the State of California OSHPD guidelines for timeliness and accuracy in the submission of data. Has a working knowledge of OSHPD’s on-line Medical Information Reporting for California (MIRCal) website.
  • Performs other duties as assigned.

• High School Graduate or equivilent required.
• Associate’s degree from an accredited College or University in Health Information Management preferred.
• Five (5) to Seven (7) years of experience in coding related functions with proficiency in at least two areas of coding (inpatient, observation, ambulatory surgery or emergency department (ED) records) required, inpatient coding experience preferred, acute care experience required.

CERTIFICATIONS/LICENSES:

• Current Registered Health Information Administrator (RHIA) Certificate, or current Registered Health Information Technician (RHIT) Certificate, or a Certified Coding Specialist (CCS) Certificate required. All of which are accredited by the American Health Information Management Association (AHIMA).

This opportunity offers the following:

• Challenging and rewarding work environment
• Growth and Development Opportunities within UHS and its Subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401k plan with company match

One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

• 
  UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc.

UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

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