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Required Skills

1. Review medical records and accurately code the principal and all secondary diagnoses and procedures using ICD-9-CM and ICD-10-CM coding conventions; sequence the diagnoses and procedures using coding guidelines; abstract and compile data from medical records to assign the most appropriate codes for optimal reimbursement.
2. Coding of Inpatient/Observation Accounts- as assigned performs coding analysis on inpatient/observation accounts utilizing 3M and /or other coding products. Prepares attestation/coding summaries/billing forms as appropriate.  Abstracts all coded records in coding system per procedure.  Assists with post bill audit as directed by Coding Manager.  Ensure the MS-DRG assignment is accurate.
3. Participates in required continuing education and compliance training programs to maintain an understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to support the effective application of ICD-9-CM and ICD-10- CM coding guidelines to inpatient diagnoses and procedures. Staff will maintain up-to-date knowledge of medical records practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Centers for Medicare and Medicaid (CMS), Federal Intermediary (FI) and other related organizations.
4. Ensures compliance with all current Memorial Medical Center and department policies and procedures.
5. Review the complex (problematic coding that needs research and reference checking) medical records and accurately codes the primary/secondary diagnoses and procedures using ICD-9-CM and ICD-10-CM coding conventions. Assist with research and development, and presentation of continuing education programs on areas of specialization.
6. Productivity (quantity & quality) is a higher level than for Healthcare Coding Associate and Healthcare Coding Specialist.
7. Communicates with patient services to resolve billing/coding matters. Demonstrates ability to cooperate with Memorial Medical Center management personnel, physicians and other persons contacted during the working day.  Works directly with physician and Allied Medical Staff to clarify coding issues.  Utilizes physician documentation query form effectively.
8. Enter and retrieve patient medical data from computer terminal updating entries as necessary; audit medical record for accuracy and completeness, note deficiencies and refer for appropriate follow up and completion.
9. Assist with the training of employees in the use of coding manuals; review difficult classification situations and determine the most appropriate codes; monitor work of subordinate employees to ensure accuracy and completeness of assignments.
10. Participates in monthly coding meetings with Coding supervisors, CDI team, and others, as determined.
11. Serve as a member of designated divisional committees and other steering committees as appropriate.
12. Promotes MHS Guest Relations philosophy, Statement of Values, and follows MHS Behavior Standards and Code of Conduct.
13. Performs other related work as required or requested.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.

Required Skills

• Accesses Web Based Portals and Downloads ERA, ACH and report files from payors.
• Prepares files for processing, initiates and monitors Posting Software Applications ensuring careful adherence to guidelines, timeliness, accuracy, and processing procedures. At prescribed intervals, follows up for review to ensure smooth processing and timely delivery of outstanding payments.
• Investigates assigned payments with incomplete or questionable information and resolves problems or errors to ensure complete information accompanies the payment.
• Calculates contractual adjustments and applies to patients’ online accounts, notating the electronic file accordingly.
• Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values: 
• Receives, sorts, and stamps incoming United States Post Office and Inter-department mail. Identifies and Batches 3^rd Party and Patient payments for processing. Bundles and/or delivers mail correspondence team for attention and handling.
• Processes and analyzes explanation of benefit (EOB) forms to determine reasons for denial, exclusion, or under payment.
• Follows up on outstanding or unapplied payments and other issues associated with payments.
• Researches and resolves complex issues associated with payments on patient accounts. As applicable, identifies, documents, and reports problematic trends to management.
• Analyzes reports containing rejected payment information and performs the necessary research to resolve the reason(s) for the rejection and secures any other required information.
• Prepares daily bank deposit and arranges for daily delivery or pick to/from the Security Department. Ensures the security of deposit at all times.
• Provides input regarding system edits designed to identify and ensure consistent and compliant data necessary for processing patient payments.
• Communicates and resolves issues with a variety of internal sources to resolves issues involving patient payments.
• Initiates corrections to charges and contractuals / allowances within scope of expertise and authority granted.
• Adhere to HIPAA Privacy Regulations and maintain patient confidentiality
• Identifies and calculates write-off amounts and secures the necessary approvals from management for processing.
• Documents online systems and electronic files to ensure accurate data is noted regarding the status of payments.
• Performs a variety of filing and/or retrieval of electronic and paper forms and files. Maintains files according to prescribed procedures and may arrange for long-term storage of EOBs or other items.
• As directed and defined by management, orients and cross-trains on other unit duties which are outside of regularly assigned area of responsibility. May serve as a back up for other areas within the unit or department, especially during times of special needs or staff absences.
• Performs other related work as required or requested.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.

Required Skills

• Practitioner:  Provides quality patient care and coordinates nursing practice through a comprehensive approach to the management of patients with conditions related to specialty and with environmental issues related to infection control.

• Mentor:  Role models an integrated approach toward patient care.  Serves as a clinical leader consultant to health care providers within the hospital system and to the community for nursing practice issues related to specialty knowledge.

• Educator:  Provides educational programs to patients, families, staff and students.  Participates in orientation, competency assessment, and ongoing education of staff and students.

• When assigned one-on-one care to a patient that is perceived to be harmful to themselves or others, positions self in patient room at bedside to maintain constant visual observation of the patient and remain within arm’s length of patient.  Never leaves the patient alone or out of sight unless specifically instructed.

• Performs other duties as assigned.

Required Skills

Greets patients/family members and offers assistance.

Completes all steps of pre-registration/registration including patient interview, collects insurance information, obtains photo identification and signatures for consent and distributes required patient information.

Coordinates accurate patient data collection to verify insurance eligibility and determines financial obligation, which may include collection of copayments.

Ensures compliance with all applicable HIPAA, Joint Commission, CDC, TMH and state and federal statues, providing required associated literature to patients at all PAS access points.

Responds to all emergency procedures.

Pushes/Assists patients in wheelchairs to the location of the service they need.

Communicates with co-workers and Manager on follow-up or concerns.

Demonstrates an ability to be flexible, organized and function well in a stressful situation.

Prioritizes the order of assisting patients based on the most critical patients first.

Assists with training of new personnel.

Maintains a professional demeanor at all times and demonstrates respect towards all patients, customers, peers and leadership.

Demonstrates an ability to be flexible, willing to work alternative shifts and cover call-ins as needed. May be required to work night or weekend shifts.

Demonstrates superior patient relations and interpersonal skills; demonstrates and appropriate level of mental and emotional tolerance and even temperament when dealing with staff, patients and general public, using tact, sensitivity and sound judgment; promotes a positive work environment and contributes to the overall team efforts of the department and organization.

Communicates the mission, vision and goals of the organization and department.

Demonstrates understanding of department policies and procedures.

Arranges self-directed learning and participates in continuing education on an annual basis.

Performs other job related duties and special projects as assigned by the Manager.

Required Skills

1.  Communication

• Promptly and courteously greets others in a friendly manner.

• Receives and directs others by using AIDET and Greet & Feet.

• Within scope of job description, responds to questions and provides direction.

• Facilitates telephone, verbal, written, and electronic communication with nursing staff, physicians, patients, and visitors promptly, accurately, and professionally.

• Consistently uses the Physician Profile to ascertain the correct method/number to page physicians.

• Updates and maintains call light system assignments accurately and efficiently during each shift.

• Appropriately utilizes the Patient Tracking system in communicating with the Patient Placement Office.

2.  Information Processing

• Prioritizes stat orders and immediate needs.

• Processes orders accurately.

• Accurately inputs data into the electronic medical record and maintains accurate paper records for those items that are not computerized.

• Refers patient/visitor concerns to nursing and/or customer service staff.

• Refers news media to nursing or public relations staff.

• Demonstrates safe, accurate, and effective use of office equipment.

• Writes legibly and clearly.

3.  Medical Records Maintenance

• Assembles chart forms.

• Puts patient identifier on all chart forms.

• Thins charts when needed and forwards documents to Medical Records.

• Files patient data after review by nurse.

• Sends discharge patient record to Medical Records.

• Gathers and copies appropriate paperwork from the RN for patient transfers to other units and facilities.

• Manages large amounts of sensitive and confidential information concerning patient and family information in medical documents.

4.  Service Requisitions

• In partnership with the Nursing Material Specialists, assures adequate supplies are available.

• Reviews receipts of new supplies and equipment upon arrival; validates accuracy and places supplies in assigned location.

• Sends service requisitions to interdisciplinary departments.

• Promptly and accurately enters data and maintains unit activity sheets as directed.

• Maintains equipment logs and facilitate maintenance of equipment with Biomed or appropriate department.

5.  Unit Operations

• Utilizes time and resources effectively and efficiently.

• Assists in maintaining safe environment and reports unsafe conditions.

• Completes assigned tasks accurately and timely.

• Completes basic patient care tasks as directed by registered nurse.
• Freshens drinking water.
• Serves/collects food trays.
• Responds to call lights and bed/chair alarms.
• Provides 1:1 direct and constant patient observation as delegated.

• Expedites timely admission, discharge, and transfer of patients to facilitate patient flow.

• Participates in QI activities; maintaining logs, statistical records, and data collection.

• Acts as a preceptor as needed.

• Handles medications delivered from pharmacy directly or through the pneumatic tube system. Relocates these medications, in original containers, to designated secure storage locations or delivers directly to appropriate licensed staff.

• May serve as the second person to witness the wasted amount of a controlled substance in the Pyxis.

• Assists with stocking unit supply stations.

6.  Accountability

• Complies with established policies, procedures, standards, and guidelines.

• Follows the chain of command.

• Consistently utilizes time and resources effectively and efficiently.

• Maintains cleanliness of unit, service area, and equipment.

• Cooperates with all members of the healthcare team.

• Enthusiastically supports and participates in planned changes.

• Accepts responsibility for accurate and timely completion of tasks as assigned.

• Upholds the mission and vision of MHS.

7.  Performs other related work as required or requested.

Required Skills

Essential Functions and Job Duties

• CLINICAL JUDGEMENT – Clinical reasoning, which includes decision-making, critical thinking, and a global grasp of the situation, coupled with nursing skills acquired through a process of integrating formal and informal experiential knowledge and evidence-based guidelines.
• Demonstrates the ability to assess the full scope of patient needs, using the nursing process on a continuous basis.
• Utilizes past nursing experience to anticipate problems while seeking out multi-disciplinary collaboration with comfort, when necessary.
• Recognizes patterns and trends that may predict the direction of illness.
• CARING PRACTICES:  Nursing activity that create a compassionate, supportive, and therapeutic environment for patients/families and staff.  Working on another’s behalf and representing the concerns of the patient/family and nursing staff; serving as a moral agent in identifying and helping to resolve ethical and clinical concerns within and outside the clinical setting.
• Promotes safety throughout patient’s and family’s transitions along the healthcare continuum.
• Actively anticipates and monitors patient and family changes, responds appropriately.
• Effectively resolves patient complaints.
• Engages all patients in a personalized, compassionate manner.
• COLLABORATION/SYSTEMS THINKING – Working with others (e.g., patients, families, healthcare providers) in a way that promotes/encourages each person’s contribution toward achieving optimal/realistic patient/family goals.  Involves intra-and inter- disciplinary work with colleagues and community.  Body of knowledge and tools that allow the nurse to manage whatever Environmental and system resources exist for the patient/family and staff, within or across healthcare and non-healthcare systems.
• Consults and coordinates with team members to assess, plan, implement and evaluate patient care plans.
• Actively utilizes evidence-based practice and customer service data to improve caring practices.
• Effectively plans and communicates patient care plans.
• Facilitates active involvement of others in team meetings regarding patient care and/or practice issues.
• Seeks out opportunities to be taught, coached, and mentored.
• Recruits diverse resources when appropriate to optimize patient outcomes.
• Serves as a resource to department and patient/family.
• RESPONSE TO DIVERSITY – The sensitivity to recognize, appreciate and incorporate differences into the provision of care.  Differences may include, but are not limited to, cultural differences, personalities, spiritual beliefs, gender, race, ethnicity, lifestyle, socioeconomic status, age, and values.
• Integrates cultural differences into patient/family care; incorporates appropriate alternative therapies.
• Tailors healthcare culture to meet the diverse needs and strengths of each patient/family. 
• FACILITATION OF LEARNING – The ability to facilitate learning for patients/families, nursing staff, other members of the healthcare team, and community.  Include both formal and informal facilitation of learning.
• Develops and modifies patient/family education programs throughout delivery of care, collaborating and incorporating all healthcare providers’ and educational plans.
• Provides individualized care.
• Evaluates patient’s understanding by observing behavior changes throughout plan of care.
• Sets patient-driven goals for education.
• Work toward achieving Bachelor of Science in Nursing degree.
• CLINICAL INQUIRY (INNOVATOR/EVALUATOR) – The ongoing process of questioning and evaluating practice and providing informed practice.  Creating practice changes through research utilization and experimental learning.
• Adapts standards of care to serve particular patient populations.
• Seeks out advice to improve patient care.
• Evaluates current practices based on patient responses, analysis of literature, research, and education.
• Incorporates evidence based practice into care delivery.
• Actively pursues continuing educational opportunities.
• Performs other duties as assigned.

Required Skills

Essential Functions and Job Duties

• CLINICAL JUDGEMENT – Clinical reasoning, which includes decision-making, critical thinking, and a global grasp of the situation, coupled with nursing skills acquired through a process of integrating formal and informal experiential knowledge and evidence-based guidelines.
  • Demonstrates the ability to assess the full scope of patient needs, using the nursing process on a continuous basis.
  • Utilizes past nursing experience to anticipate problems while seeking out multi-disciplinary collaboration with comfort, when necessary.
  • Recognizes patterns and trends that may predict the direction of illness.
• CARING PRACTICES:  Nursing activity that create a compassionate, supportive, and therapeutic environment for patients/families and staff.  Working on another’s behalf and representing the concerns of the patient/family and nursing staff; serving as a moral agent in identifying and helping to resolve ethical and clinical concerns within and outside the clinical setting.
  • Promotes safety throughout patient’s and family’s transitions along the healthcare continuum.
  • Actively anticipates and monitors patient and family changes, responds appropriately.
  • Effectively resolves patient complaints.
  • Engages all patients in a personalized, compassionate manner.
• COLLABORATION/SYSTEMS THINKING – Working with others (e.g., patients, families, healthcare providers) in a way that promotes/encourages each person’s contribution toward achieving optimal/realistic patient/family goals.  Involves intra-and inter- disciplinary work with colleagues and community.  Body of knowledge and tools that allow the nurse to manage whatever Environmental and system resources exist for the patient/family and staff, within or across healthcare and non-healthcare systems.
  • Consults and coordinates with team members to assess, plan, implement and evaluate patient care plans.
  • Actively utilizes evidence-based practice and customer service data to improve caring practices.
  • Effectively plans and communicates patient care plans.
  • Facilitates active involvement of others in team meetings regarding patient care and/or practice issues.
  • Seeks out opportunities to be taught, coached, and mentored.
  • Recruits diverse resources when appropriate to optimize patient outcomes.
  • Serves as a resource to department and patient/family.
• RESPONSE TO DIVERSITY – The sensitivity to recognize, appreciate and incorporate differences into the provision of care.  Differences may include, but are not limited to, cultural differences, personalities, spiritual beliefs, gender, race, ethnicity, lifestyle, socioeconomic status, age, and values.
  • Integrates cultural differences into patient/family care; incorporates appropriate alternative therapies.
  • Tailors healthcare culture to meet the diverse needs and strengths of each patient/family. 
• FACILITATION OF LEARNING – The ability to facilitate learning for patients/families, nursing staff, other members of the healthcare team, and community.  Include both formal and informal facilitation of learning.
  • Develops and modifies patient/family education programs throughout delivery of care, collaborating and incorporating all healthcare providers’ and educational plans.
  • Provides individualized care.
  • Evaluates patient’s understanding by observing behavior changes throughout plan of care.
  • Sets patient-driven goals for education.
  • Work toward achieving Bachelor of Science in Nursing degree.
• CLINICAL INQUIRY (INNOVATOR/EVALUATOR) – The ongoing process of questioning and evaluating practice and providing informed practice.  Creating practice changes through research utilization and experimental learning.
  • Adapts standards of care to serve particular patient populations.
  • Seeks out advice to improve patient care.
  • Evaluates current practices based on patient responses, analysis of literature, research, and education.
  • Incorporates evidence based practice into care delivery.
  • Actively pursues continuing educational opportunities.
• Performs other duties as assigned.

Required Skills

1. Interprets, orders, and generates barcode labels from the Lab LIS system and applies labels to appropriate specimen tubes and collection containers. Must be able to interpret many different physician orders and requests to include over 1800 lab tests and select the appropriate orderable code in the Lab LIS system.

1. Removes biological specimens from biohazard bags including blood, urine, bone marrow, body fluids, and tissue specimens. Understand all different types of collection media, preservatives, and risks of exposure to infectious agents. Handles both infectious A and B substances with appropriate CDC, and IDPH guidelines. Ability to determine if specimen was collected in appropriate collection container and media. Understands steps to resolve collection issues to ensure patient testing is performed or recollected.

1. Receives all calls arriving in the laboratory from providers, clients, nurses, management, and patients. Logs calls in tracking software, answers all questions pertaining to phlebotomy draws, specimen collection, transport of specimens, provides lab results, supply requests, forensic autopsy cases, and administrative questions. Escalates callers to management or technical departments when necessary if unable to resolve all question  

1. Correctly enters outpatient and non-patient demographic, insurance, and diagnosis information into the hospital registration system, answering all questions in each field and updating any information that is not current. Understands insurance policy numbers and carrier codes including client account versus patient insurance billing. Recognizes valid diagnosis codes and follows appropriate resolution on any noncompliant codes.

Required Skills

1. Works independently to Interprets routine and complex testing orders, and generates barcode labels from the Lab LIS system and applies labels to appropriate specimen tubes and collection containers. Must be able to interpret many different physician orders and requests to include over 1800 lab tests and select the appropriate orderable code in the Lab LIS system.

1. Removes biological specimens from biohazard bags including blood, urine, bone marrow, body fluids, and tissue specimens. Understand all different types of collection media, preservatives, and risks of exposure to infectious agents. Handles both infectious A and B substances with appropriate CDC, and IDPH guidelines. Ability to determine if specimen was collected in appropriate collection container and media. Understands steps to resolve collection issues to ensure patient testing is performed or recollected.

1. Receives all calls arriving in the laboratory from providers, clients, nurses, management, and patients. Logs calls in tracking software, answers all questions pertaining to phlebotomy draws, specimen collection, transport of specimens, provides lab results, supply requests, forensic autopsy cases, and administrative questions Handles all calls that are escalated to ensure appropriate feedback is provided to the caller and management to include QA review of all repeat issues.

1. Correctly enters outpatient and non-patient demographic, insurance, and diagnosis information into the hospital registration system, answering all questions in each field and updating any information that is not current. Understands insurance policy numbers and carrier codes including client account versus patient insurance billing. Recognizes valid diagnosis codes and follows appropriate resolution on any noncompliant codes.