Certified Coding Specialist Sr

Responsibilities

• Analyzes relevant clinical and demographic information from the Health Information record, assigns appropriate ICD-10 and CPT codes following appropriate guidelines and ascertains that the above are compliant with CMS, state and other regulatory agencies.
• Mentorship and training to on-boarding coders.
• Completes analysis of documentation, abstracting and code assignment by body system, organ, etiology and morphology according to the American Hospital Association Official ICD-10 Coding Guidelines (Coding Clinic), CPT4/HCPCS Coding Guidelines, ASC groups, UHDDS Guidelines, HCFA methodology guidelines for coding, state and federal guidelines and hospital abstracting guidelines.
• Performs queries and obtains documentation required for coding for records maintained in other departments.
• Collaborates with the Clinical Documentation Specialist to coordinate documentation needs, query follow-up and final DRG assignment.
• Reviews provider documentation for coding appropriateness, analyzes medical records to complete accurate code selection.
• Maintain communication with Management and Providers to ensure timely notification of identified documentation issues.
• Assigns diagnosis and procedure codes for clinic visits, surgical procedures/deliveries, and other billable professional services.
• Assist with inquiries regarding coding, documentation.
• Maintain focus on appropriate queries and education regarding appropriate HCC diagnoses documentation and capture.

Qualifications

• Knowledge of medical terminology, anatomy and physiology, coding and application.
• Knowledge of various computer applications including Windows, Excel, healthcare information systems and encoders.
• One of the following certifications: CCS: Certified Coding Specialist, CPC: Certified Professional Coder, CRC: Certified Risk Adjustment Coder, RHIT: Registered Heath Information Technologist, RHIA: Registered Health Information Administrator.
• Two years of coding experience.