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Apprenticeship Registered Apprenticeship Occupation Information


H

Health Information Management (HIM) Hospital Coder
Use and maintain electronic applications and work processes to support clinical classification and coding. Apply diagnosis and procedure codes according to current nomenclature. Ensure accuracy of diagnostic/procedural groupings such as DRG (Diagnosis Related Group), MSDRG (Medicare Severity), APC (Ambulatory Payment Classification), etc. Validate coding accuracy using clinical information found in the health record. Adhere to current regulations and established guidelines in code assignment. Use and maintain applications and processes to support other clinical classification and nomenclature as appropriate to the work setting. Resolve discrepancies between coded data and supporting documentation. Communicate with physicians and other care providers to ensure appropriate documentation. Apply policies and procedures for the use of clinical data required in reimbursement and prospective payment systems (PPS) in healthcare delivery. Apply policies and procedures to comply with changing regulations among various payment systems for healthcare services such as Medicare, Medicaid, managed care, etc. Support accurate billing through coding, chargemaster, claims management, and bill reconciliation processes. Use established guidelines to comply with reimbursement and reporting requirements such as the National Correct Coding Initiative and others. Compile patient data and perform data quality reviews to validate code assignment and compliance with reporting requirements such as outpatient prospective payment systems. Ensure accuracy of diagnostic/procedural groupings such as DRG and APC. Participate in compliance (fraud and abuse), HIPAA (Health Insurance Portability and Accountability Act of 1996), and other organization specific training.
Occ
Code
Program NameProgram HoursSponsorRegionDistrict
2029CBTampa General Hospital INJ
FL002017712
2000Diane Lerch 4Hillsborough