The Mid Yorkshire Teaching NHS Trust

Senior Clinical Coder

The closing date is 03 October 2025

Job summary

The Clinical Coding Department is responsible for the accurate and timely recording of clinical data to support the Trusts clinical and business requirements and for regional and National Health Service statistics. Our Trust recognises the vital contribution of our coding team to our overall Trust performance and regards our team as pivotal to our future performance. The post holder will be required to work as a member of a team to provide an efficient clinical coding service working to established systems and procedures. To screen medical records, discharge summaries and other data sources to extract clinical information relevant to a patients episode of care. Through effective data extraction analyse complex clinical information; apply independent judgement in the interpretation, translation and sequencing of clinical data adhering to national rules and conventions. To code all patient episodes using the M360 Solventum encoding system supported by International Classification of Diseases (ICD 10) and Office of the Population of Census and Surveys (OPCS 4) coding classifications. Ensure data is entered accurately into the Patient Administration System within nationally/locally defined timescales. Communicate and liaise effectively with clinicians, nursing staff, other professionals and departments, both internal and external, concerning routine or complex issues / anomalies across all specialties whilst maintaining good relationships.

Main duties of the job

Screen medical records, discharge summaries, histopathology results and other data sources to extract clinical information relevant to a patients episode of care. Through effective data extraction analyse complex clinical information; apply independent judgement in the interpretation, transposition and sequencing of clinical data adhering to national rules and conventions. Code all patient episodes using the M360 Solventum encoding system supported by International Classification of Diseases (ICD 10) and Office of the Population of Censuses and Surveys (OPCS 4) coding classifications. Exercise initiative in selecting appropriate clinical terms to accurately reflect the individual patient record. Ensure data is entered accurately into the Patient Administration System (PAS) within national defined timescales. Regularly required to access and read patient case notes where the content can be distressing. Develop and maintain skills to use the PAS system and adhere to local coding protocols/procedures. Check patient details held on the system are correct e.g. consultant, date of admission and discharge reporting any incorrect details to the Data Quality Team. Routinely run outstanding episode reports from the Patient Administration System and action by searching for missing source documentation. Code complex specialties including mortality coding. Maintain and update knowledge in accordance with national clinical coding standards changes.

About us

We are an acute trust caring for over one million people in Wakefield and Kirklees. Our 10,000 staff members work in patients homes, the community, and our three hospitals in Pontefract, Dewsbury, and Pinderfields (Wakefield). Committed to continuous improvement, we prioritise our people and values so we can deliver excellent patient experience. Our team is friendly, passionate and always seeking better ways to work through research and innovation. We support work-life balance and foster a diverse, inclusive environment where everyone belongs. Our staff networks offer safe spaces for honest conversations and to share ideas, thoughts and concerns so we can increase awareness and appreciation of equality, diversity, and inclusion. As a member of the team, you will have access to the NHS pension plan, a generous holiday allowance, employee health and wellbeing services and extensive benefits and support. These include onsite nurseries, childcare vouchers, car lease and home electronics schemes, working carers support, carer-friendly policies, and more. If you value caring, high standards, improvement, and respect, join the MY team to make a difference every day.

Date posted

26 September 2025

Pay scheme

Agenda for change

Band

Band 5

Salary

£31,049 to £37,796 a year

Contract

Permanent

Working pattern

Full-time

Reference number

000675

Job locations

Pinderfields Hospital

Wakefield

West Yorkshire

WF1 4DG

Job description

Job responsibilities

Essential person specification requirements

Qualifications:

Minimum A level qualification or equivalent qualification or equivalent knowledge.
Undertaken the Clinical Coding Standards Course.
Up to date with Clinical Coding Refresher Courses.
National Clinical Coding Qualification.
Successful completion of a coder audit.

Experience:

The principles of Clinical Coding.
Significant knowledge of anatomy and physiology and medical terminology.
Significant knowledge of clinical coding requirements and standards.

Knowledge and Awareness:

Knowledge of the importance of confidentiality, the Data Protection Act and Caldicott Principles.
Thorough knowledge of Patient Administration Systems.
Understanding of how acute hospital services function in relation to patient experience.
Awareness of own limitations.

Job description

Job responsibilities

Essential person specification requirements

Qualifications:

Minimum A level qualification or equivalent qualification or equivalent knowledge.
Undertaken the Clinical Coding Standards Course.
Up to date with Clinical Coding Refresher Courses.
National Clinical Coding Qualification.
Successful completion of a coder audit.

Experience:

The principles of Clinical Coding.
Significant knowledge of anatomy and physiology and medical terminology.
Significant knowledge of clinical coding requirements and standards.

Knowledge and Awareness:

Knowledge of the importance of confidentiality, the Data Protection Act and Caldicott Principles.
Thorough knowledge of Patient Administration Systems.
Understanding of how acute hospital services function in relation to patient experience.
Awareness of own limitations.

Person Specification

Qualifications

Essential

Please click 'apply now' to view the full person specification (there is no obligation to submit an application).

Person Specification

Qualifications

Essential

Please click 'apply now' to view the full person specification (there is no obligation to submit an application).

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.