Coding Specialist [AQ-12133]

About the Role

Join a team where your expertise directly contributes to the accuracy and efficiency of healthcare operations, ensuring that every patient’s journey is meticulously documented and appropriately supported. Step into a pivotal role where your expertise will directly shape the financial health and operational excellence of a leading healthcare organization. As a vital member of the team, you will be instrumental in maintaining the highest standards of medical coding, ensuring precision in patient data and supporting critical decision-making. Your work will have a tangible impact, contributing to accurate reimbursement and the seamless flow of essential healthcare services.

Responsibilities

• Review medical record documentation and accurately assign appropriate diagnostic and procedural codes (ICD-10-CM/PCS) for inpatient services.
• Determine the correct payment groups, such as Medicare Severity-Diagnosis Related Group (MS-DRG) or All Patient Refined Diagnosis Related Group (APR-DRG), ensuring accurate reimbursement.
• Verify patient discharge disposition, assign correct sources of admission, and apply appropriate present on admission (POA) indicators for regulatory reporting.
• Ensure all assigned codes accurately reflect the documented reason for the visit and support the care provided.
• Abstract required data elements per facility specifications and maintain compliance with federal, state, and third-party regulations, as well as professional coding guidelines and ethics.
• Collaborate effectively with clinical documentation specialists and medical staff to clarify documentation, obtain missing information, and ensure comprehensive medical records.
• Monitor accounts for timely and compliant processing through the revenue cycle, contributing to the organization’s financial integrity.
• Consistently meet and exceed established quality and productivity standards for coding and abstracting.
• Stay abreast of current requirements from relevant regulatory bodies, coding compliance initiatives, quality indicators, and patient safety indicators to ensure clean claims and optimal reimbursement.
• Utilize industry-standard coding and auditing tools and reference materials with high competency and accuracy.
• Participate in required meetings and educational sessions, completing annual learning programs to ensure continuous professional growth and maintain expertise.

Requirements

• High School Diploma or GED.
• Successful completion of a Coder Proficiency Exam (pre-hire).
• Certifications: One of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS).
• Expertise in ICD-10-CM/PCS coding conventions for inpatient medical records.
• In-depth knowledge of diagnosis/procedure grouping schemes, including MS-DRGs and APR-DRGs.
• Strong understanding of professional coding ethics and standards, and the ability to apply professional data set standards.
• Familiarity with health information systems and industry-standard coding and auditing software.
• Knowledge of regulatory body requirements and coding compliance issues.
• Demonstrated ability to review, analyze, and abstract complex information from medical documentation.
• Exceptional critical thinking, problem-solving, and decision-making skills.
• Excellent written and oral communication skills, fostering effective working relationships and building consensus with individuals at all levels of the organization.
• Ability to work independently, manage time effectively, prioritize tasks, and adapt to changing priorities in a fast-paced environment.
• Commitment to maintaining accuracy and productivity standards.
• Comprehensive knowledge of medical terminology, anatomy, physiology, and disease processes.

Employment Requirements

• Be authorized to work in the United States.
• Not require sponsorship of any kind for the duration of the assignment.
• Be able to work on a W-2 basis. C2C or 1099 is not permitted for this position.

Schedule

Monday – Friday, 8:00 AM – 5:00 PM and be able to work weekends when needed.

Benefits

Eligible talent get access to amazing benefits including:

• Subsidized health, vision, and dental plans.
• Paid sick leave.
• Retirement plans with a match.
• Free online training through Aquent Gymnasium.