Job Description

To analyse and extract diagnostic and procedural information from patient case notes, other source documentation as appropriate and information systems and assign the appropriate code, in accordance with local and national clinical coding standards in an accurate and timely fashion.



To provide an efficient and high quality clinical coding service to support the business needs of the Trust, including Clinical Governance, Information Governance and finance by ensuring accurate translation and input of medical terminology.



To analyse the information available using policies, procedures and guidelines and local and national coding rules and conventions to translate this information into the appropriate codes as set out by national guidance (OPCS 4 and ICD-10 or any classification that may be implemented in the future.) To deal with coding queries as and when is necessary throughout the working day and to communicate complex coding rules to medical, clinical, administration staff and external agencies.

Our people are our greatest asset. When we feel supported and happy at work, this positivity reaches those very people we are here for, the patients. Engaged employees perform at their best and our Equality, Diversity & Inclusion (EDI) initiatives contribute to cultivate a culture of engagement. We have four staff networks, a corporate EDI Team and a suite of programmes and events which aim to insert the 5 aspirations:



Improving representation at senior levels of staff with disabilities, from black, Asian, and ethnic minorities background, identify as LGBTQ+ and women, through improved recruitment and leadership development



Widening access (anchor institution) and employability



Improving the experience of staff with disability



Improving the EDI literacy and confidence of trust staff through training and development



Making equalities mainstream



Researching the appropriate codes to use (ICD and OPCS) referring to both local and national coding rules, conventions and policies. To access a variety of information systems, e.g. pathology, to obtain other information to inform the coding process and to ensure the completeness and accuracy of coding by checking results both in real time and by following missing results.



To support the Divisional Lead Coding Analyst in dealing with the uncoded lists, and ensure all outstanding coding is cleared as a priority without compromising data quality and meeting coding deadlines.



To identify data quality queries on Icare, for example patients not admitted, transferred and discharged, wrong Consultants and dates and liaising with Directorate or IT staff to ensure the issue is addressed.



To identify any data quality issues with the encoded data, where the system is not accepting the codes, and escalating as necessary to the Divisional Coding Lead.



To alert the Divisional Lead Coding Analyst to major problems identified with the patient administration system or the encoder.



To analyse the information available using policies, procedures and guidelines and local and national coding rules and conventions to translate this information into the appropriate codes as set out by national guidance (OPCS 4 and ICD-10 or any classification that may be

implemented in the future.)