• Account for coding and abstracting of patient medical appointments • Research and analyze data needs for reimbursement • Ensure codes are properly sequenced • Analyze, file, and process medical records • Keep detailed documentation of any deficiencies or issues with medical records • Provide education and training to other coding staff • Review and verify documentation

• Demonstrates the ability to perform quality surgical coding and multispecialty chart types as assigned • Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing • Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes • Seeks to attain proper documentation in a timely manner according to facility standards • Achieves and maintains 97% accuracy in coding while maintaining a high level of productivity • Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary • Responsible for coding or pending every chart placed in their queue within 24 hours • Communicates problems or coding principle discrepancies to their supervisor immediately

• Accurately assign ICD-10-CM, CPT, and HCPCS codes for Behavioral Health and SUD services across inpatient and outpatient settings. • Review clinical documentation to ensure coding accuracy, completeness, and compliance with federal and state regulations. • Apply coding guidelines specific to mental health and substance use treatment, including outpatient behavioral health and inpatient consult services. • Identify documentation gaps and work collaboratively with providers and clinical staff to improve coding quality and documentation standards. • Ensure coding supports medical necessity and payer requirements. • Stay current with coding updates, payer policies, and regulatory changes related to Behavioral Health and SUD services. • Assist with coding audits, respond to audit findings, and implement corrective actions as needed. • Maintain productivity and accuracy benchmarks as defined by the organization. • Support billing and revenue cycle teams by resolving coding-related denials or questions.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a part of our Coding Quality team, our coding editors play an integral role in reviewing coding quality alerts and/or billing edits for hospital, outpatient, and ambulatory encounters. This team will also review coding denials and evaluate areas of improvement throughout the revenue cycle process. - Verifying accuracy of assigned CPT codes for complex and/or error-prone procedures. - Verifying diagnosis coding accuracy for complex and/or error-prone encounters. - Reviewing charge and procedure mismatches. - Reviewing codes with revenue integrity edits for NCD/LCD coverage. - Reviewing invalid codes, code conflicts, and missing modifiers. - Working with other teams in billing, revenue integrity, coding operations, coding compliance, and other revenue cycle counterparts. - Combining codes for payment window encounters. - Assisting with resolution of accounts with HIM/Coding unbilled hold reasons preventing final billing. - Validating certain discharge dispositions. - Assigning appropriate diagnosis and procedure codes for inpatient and/or outpatient episodes of care. - Assisting other coders by training and advising on coding and abstracting. - Assisting in resolving billing edits that are holding patient claims from billing. - Identifying ways to improve work processes and improve customer satisfaction. - Serving as a liaison between management, coders, physicians, nurses, medical staff, Patient Financial Services, and hospital employees. - Maintaining a positive working relationship to ensure that medical record information is documented and coded according to established conventions. - Assisting in the identification and reporting of potential quality issues. - Ensuring unbilled items are addressed properly and timely. - Identifying and reviewing charging, coding, and clinical documentation issues. Qualifications - Must have successfully completed an approved coding program OR be a graduate of a Health Information Management program. - Must have five years of coding experience in an acute care hospital environment. - May have an equivalent combination of education and experience in lieu of specific education and/or experience as stated above. - Must be certified through the American Health Information Management Association or the American Association of Procedural Coders. Requirements - Must be able to demonstrate advanced knowledge of coding and abstracting skills. - Applicants must pass applicable coding test with an 85% or above prior to placement into position. - Must be able to demonstrate knowledge of reimbursement (Medicare and Medicaid) principles. - Must have extensive knowledge of medical terminology, the human disease process, anatomy, and physiology. - Must be able to demonstrate good organizational and leadership skills. - Must be able to communicate effectively, both orally and in writing. - Must be able to demonstrate knowledge of computer software applications including MS Office. Benefits - This position is 100% Virtual. - Virtual employees must comply with all Parkland policies and procedures governing the use of Parkland information resources. - Virtual employees must maintain all equipment lent by Parkland for performing the agreed-upon job duties in good working condition.