Coding Quality Assurance Specialist III

Responsibilities

• Assigns ICD-10-CM, ICD-10-PCS, and/or CPT codes.
• Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.
• Communicates with and provides feedback to the education team and/or providers.
• Reviews patient charges to determine necessary coding to complete the account.
• Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.
• Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
• Sequences diagnosis and procedures to generate appropriate billing.
• Queries physicians to obtain diagnosis if not clearly provided in records.
• Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, and coding reference materials).
• Affords assistance to other coders in resolving coding problems.
• Provides ICD-10 and CPT for physician research projects and for quality reporting purposes.
• Completes abstracts for records as appropriate.
• Affords assistance in correcting problem accounts.
• Reviews charts for completeness.
• Participates in education and maintains certification.
• Affords assistance in auditing records.
• Maintains concurrent coding for inpatient records.

Requirements

• H.S. Diploma or equivalent
• Certified Coding Associate (CCA) by the American Academy of Professional Coders (AAPC)
• Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA)
• Certified CCS-P (Physician Based) by the American Health Information Management Association (AHIMA)
• Certified Inpatient Coder (CIPC) by the American Academy of Professional Coders (AAPC)
• Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC)
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC)
• Certified Risk Adjustment Coder (CRC) by the American Academy of Professional Coders (AAPC)
• Certified Reg Health Inform. Admins (RHIA) by the American Health Information Management Association (AHIMA)
• Certified Reg Health Inform. TECH (RHIT) by the American Health Information Management Association (AHIMA)
• 4 years coding experience
• Prior experience in Hematology and Oncology coding
• Preferred: Certified Hematology and Oncology Coder (CHONC) credentials