Job Summary
South Tyneside and Sunderland NHS Foundation Trust are seeking to recruit dedicated and enthusiastic individuals with excellent communication skills, good organisational skills, and a desire to learn to join our Clinical Coding team.
Training and development are important to us. We offer full support from internal training programmes and assessments delivered by an accredited Clinical Coding Trainer, as well as support from our internal Accredited Clinical Coders and Audit Manager.
The post holder must ensure the accuracy and timely allocation of diagnostic and procedural classification codes.
Experience working within a Clinical Coding department is desirable. However, experience within other healthcare environments, either within an NHS or private hospital in the UK, will also be considered.
Main Duties of the Job
The post holder must demonstrate the ability to read and analyse patient records to help identify all relevant diagnoses, procedures, and interventions related to the current period of patient care.
To code all patient episodes applying knowledge of the information contained within ICD-10 and OPCS4 Classifications.
To ensure the completion of all patient episodes within the agreed timescales and to follow up any uncoded episodes promptly and accurately, ensuring all data is valid for the contract minimum data sets to be produced.
About Us
One Team One Trust - There are many reasons to work at our Trust. From our commitment to putting people first to our accessible services and award-winning teams. We have a passion for research, innovation, and tackling inequalities. We are committed to respect, fairness, and civility and promote a compassionate, caring, and positive culture/work environment.
We welcome all applications irrespective of race, disability, gender, sexual orientation, religion/belief, age, gender identity, marriage and civil partnership, pregnancy/maternity, and particularly those from under-represented groups. Looking after our workforce's health and wellbeing is a priority for STSFT. We also provide access to high-quality education, training, career progression, and support. Flexible working is supported via the Trust's Flexible Working Policy.
The Trust employs around 8,300 people and provides a range of hospital services to a local community of around 430,000 residents. We also provide a range of more specialised services outside this area, in some cases to a population as great as 860,000. We offer our staff outstanding benefits - Fitness Centre (SRH), libraries at both hospital sites, chaplaincy support, and access to a Childcare Coordinator to help staff with childcare arrangements.
Job Description
Job Responsibilities
To ensure the accurate and timely allocation of diagnostic and procedural codes to patients treated within South Tyneside & Sunderland NHS Foundation Trust. You will work as part of the Clinical Coding team, working on rotation at ward level and also office-based in the Clinical Coding Office.
Duties and Responsibilities of the Post:
1. To read and analyse patient records to help identify all diagnoses, operations, and procedures relevant to the current period of patient care.
2. To code all patient episodes applying knowledge of the information contained within the International Classification of Diseases (ICD-10) and the tabular list of Surgical Operations and Procedures.
3. To clarify inconsistent, doubtful, or non-specific information in a patient record by consulting with the appropriate clinician.
4. To ensure the completion of all patient episodes within the agreed timescales and to follow up any uncoded episodes promptly.
5. To code all episodes to ensure that the data is available for the contract minimum data sets to be produced.
6. Assess the quality and content of the patient's medical record and highlight shortcomings to the Coding Manager.
7. To notify Cancer Registration Out-posted fieldworker of new cancer cases that would not be picked up from Pathology, e.g., clinical cases and CT scans.
8. To assist the Clinical Coding Manager in auditing the quality of the discharge summaries.
9. To participate in training sessions relating to Clinical Coding as appropriate.
10. To cover duties of absent members of staff as required.
11. To undertake any other duties appropriate to the grade at the request of the Clinical Coding Manager.
The post holder will be expected to work towards the National Coding Qualification and undertake further training as required in order to learn or improve job-related skills.
Person Specification
Qualifications
Essential
* Basic Numeracy & Literacy Skills to Level 1 or equivalent
* IT Skills
* Educated to GCSE level A, B, or C or equivalent (preferably including English and Biology)
* Knowledge of medical terminology
* Knowledge of anatomy & physiology
* Evidence of willingness and aptitude for study
Desirable
* Willingness to work towards National Clinical Coding qualification
* Understanding of Payments by Results
* A levels
* Experience in interpretation of clinical documentation and coding abstraction techniques.
Experience
Essential
* Previous work in a healthcare environment
* Minimum 6 months experience of work in a coding environment
* Computer literate
Personal Qualities
Essential
* Outgoing, friendly personality
* Able to work to strict deadlines and cope with pressure
* Ability to work independently, as well as part of a team
* Ability to manage own workload
Analytical/Judgmental
Essential
* Able to abstract and analyse complex patient clinical records
* Able to exert judgement in the translation of clinical details to codes and in applying the classification framework.
Attitude
Essential
* Flexible approach
* Self-motivated
* Well presented
* Confident approach
Desirable
* Ability to challenge
Other
Essential
* Daily exposure to case note documentation concerning injuries, self-abuse/self-harm (overdoses, self-inflicted wounds, self-neglect, etc.), assault cases, and terminally ill patients
* Able to deal with general stresses of tough workload targets
* Able to cope with exposure to noise (constant background interruptions)
Skills
Essential
* Excellent organisational skills
* Good keyboard skills
* Excellent communication skills
* Methodical and attention to detail
* Good written and spoken English
Desirable
* Knowledge of V6 abstracting, EMR modules
* Microsoft Office
Employer Details
Employer Name
South Tyneside and Sunderland NHS Foundation Trust
Address
Sunderland Children's Centre
Durham Road
Sunderland
SR3 4AG
Employer's Website #J-18808-Ljbffr