Long term care coder (LTC) and Health information Management assistant - Good Samaritan Society – St. Vincent's
Coding for new admissions via using Sanford or CHI Epic, identifying and analyzing new codes and code changes to ensure accuracy within Long Term Care Changes. Reading and reviewing all the resident medical records and physicians progress notes in order to assign the right and up to date medical diagnosis and ensure timely and accurate billing for all payers.
- Comply with regulations and promote practice efficiency and effectiveness by having all the patient health information and documentation protected, secured, and stored in a safe location in compliance with HIPAA regulations.
- Communicating with the Director of nursing and other healthcare professionals and clinical leaders to discuss and clarify vague documentation and ensure coding accuracy.
- Assigning new codes for return from hospital residents by reviewing the resident medical chart and updating the diagnosis.
- Coding for outside facilities on as needed basis.
- Attending daily morning report with the administrator and nurse managers to discuss residents' health status and new admissions.
- Running daily morning census.
- Verify all the documents and sheets that are scanned and indexed by other workers.
- Scanning and indexing different types of documents (Progress notes, Discharge summaries, Pharmacy consultant reports, hospice documentations, and others).
- Working on Hospital Envelops by using Sanford Epic and CHI Epic, and printing out all necessary and missing documents such as inpatient status, discharge summaries, medication administration reports, history and physical notes, physical, speech and occupational therapy notes and some progress notes.
- Having all the hospital envelop documents scanned, indexed, and verified.
- Preparing monthly recertifications for the residents of the nursing home for medical professional's visits.
- Having all the recertifications signed by the medical staff, and entering the dates for the last physician visit into Point Click Care (PCC) system for each resident.
- Sending the recertifications to Sanford Pharmacy.
- Deleting discharged residents from PCC.
- Working on therapy records through interring new Physical, Speech, and Occupational therapy codes into PCC and create a new diagnosis sheet.
- Having all the therapies distributed into the doctors' binders for signatures.
- Sending Fax for outside doctors for therapy signatures.
- Attending virtual meetings with other coders and HIM workers.
- Staying updated on annual changes to medical codes and compliance guidelines.
Volunteer - Village of Barboursville Elementary School - Huntington, WV
Helping with pre-school students and the school library.
Volunteer - Good Samaritan Society – St. Vincent's
Helping residents (patients) during lunch hour.
