Coding Specialist III
Location
United States
Posted
32 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Coding Specialist III
Parkland Health
Role Description The primary purpose of the Coding Specialist III is to code and verify data necessary to ensure correct coding, abstracting, and billing on inpatient (IP) encounters. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II and modifier codes for both professional and hospital charging, coding and billing. Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland's policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered. Qualifications - High school diploma required. - Must have successfully completed an approved coding program. - OR Must be a graduate of a health Information Management program. - Must have three (3) years of coding experience in an acute care Level I trauma hospital environment. - Physician office coding, charging and billing experience preferred. - May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above. - Must be certified through the American Health Information Management Association as one of the following: - Registered Health Information Management Technician (RHIT) - Registered Health Information Management Administrator (RHIA) - Certified Coding Specialist (CCS) - (Most desired of the certifications) - OR Must be certified through the American Association of Procedural Coders (AAPC) as one of the following: - Certified Inpatient Coder (CIC) Requirements - Must score a minimum of 85% on a pre-employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement. - Must be able to demonstrate advanced knowledge of ICD-9/ICD-10-CM/PCS coding and abstracting, MS-DRG classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage. - Must demonstrate knowledge of reimbursement (Medicare and Medicaid) principles. - Advance knowledge of medical terminology, the human disease process, anatomy and physiology. - Demonstrate good organizational and leadership skills. - Must be able to effectively communicate, both orally and in writing. - Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC). - Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred. Responsibilities - Assigns appropriate principle and secondary diagnosis and procedures codes for all episodes of care on inpatient encounters ensuring appropriate DRG assignment according to ICD-10-CM/PCS conventions, guidelines and hospital policy. - Achieve and maintain 95% accuracy on quality reviews and meet assigned productivity standards. - Abstract statistical data from the medical record and enter information according to Parkland's guidelines, policies and procedures. - Demonstrate knowledge of billing, charging and coding requirements for governmental guidelines and private insurance payers. - Coach other coders by training and advising on coding and abstracting according to ICD-10-CM/PCS conventions and guidelines. - Contributes with work flow, priorities for work completion, and communicating workflow issues to the supervisor. - Collaborates with physicians and nurses by telephone or in writing to clarify or complete records. - Facilitate a positive working relationship with management, coders, physicians, nurses, medical staff, COPCs, Financial Control, Business Services and hospital employees. - Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding and abstracting of medical records. - Audits error reports and maintains departmental quality standards, prepares and submits productivity logs to supervisor, as required. - Stays abreast of the latest developments, advancements, and trends in the field of coding and abstracting of health information management. - Maintains CE hours and renew annual coding credentials. Job Accountabilities - Identifies ways to improve work processes and improve customer satisfaction. - Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops. - Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area.
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