Coding Quality Assurance Specialist II

Job Duties & Responsibilities

• Assigns ICD-10-CM, ICD-10-PCS, and CPT codes.
• Reviews and interprets documentation for appropriate diagnosis and procedures.
• Communicates with and provides feedback to the education team and/or provider.
• Identifies principle and secondary diagnoses and procedure codes from the electronic medical and/or paper record.
• Utilizes the encoder or coding books to correctly assign all ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
• Sequences diagnosis and procedures to generate appropriate ICD-10-CM, CPT, PCS, and DRG codes for billing.
• Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
• Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, Logician, and coding reference materials).
• Assists other coders in resolving coding problems/questions.
• Provides ICD-10 and CPT, for physician research projects, and reporting purposes.
• Completes abstracts for records when appropriate.
• Identifies problem accounts.
• Corrects problem accounts.
• Participates in education and maintains certification.
• Affords assistance in auditing records.
• Maintains concurrent coding for inpatient records.

Skills & Requirements

• Required H.S. Diploma or GED
• Required Licenses/Certifications:
  • CCA - Certified Coding Associate by the American Health Information Management Association (AHIMA)
  • CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)
  • CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)
  • CIPC - Certified Inpatient Coder by the American Academy of Professional Coders (AAPC)
  • COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)
  • CPC - Cert-Cert Professional Coder by the American Academy of Professional Coders (AAPC)
  • CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC)
  • RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)
  • RHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)