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PRMO:, established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke's reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
General Description of the Job Class
The Medical Records Coder II is a certified Coder. Coordinate/review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-9-CM and CPT-4 coding conventions. Review the medical record to assure specificityof diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Pediatrics, NICU and PICU experience is preferred.
Duties and Responsibilities of this Level
Coordinate/review the work of designated employees. Ensure quality and quantity of work performedthrough regular audits. (5% )
Assist with research,development and presentation of continuing education programs on areas of specialization. (5%)
Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-9-CM and CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure DRG/APC assignment is accurate.Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. (65%)
Consult with and educate physicians on coding practices and conventions in order to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. (10%)
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- 9-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures. (10%)
Assist with special projects as required. (5%)
Perform other related duties incidental to the work described herein.
Required Qualifications at this Level
High school diploma required.
RHIA certification- no experience required
RHIT certification- no experience required
CCS certification- one year of coding experience required
CPC - 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)
Knowledge, Skills, and Abilities:
Advanced ICD-9-CM & CPT-4 coding conventions
Anatomy and Physiology
Extensive DRG/APC reimbursement knowledge
Coding software familiarity
Effective written and verbal communication skills
Degrees, Licensures, Certifications:
Must hold one of the following active/currentcertifications: Registered Health Information Administrator (RHIA) Hospital Coding Registered Health Information Technician (RHIT) Hospital Coding Certified Coding Specialist (CCS) Hospital Coding Certified Professional Coder (CPC).
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
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