Coding Specialist I Inpatient Medicine

About the role

The Coding Specialist I is an entry level HM professional fee coder with less than 24 months of HM professional coding experience. This position utilizes critical thinking skills in evaluating medical necessity in regulatory policies. Responsibilities include assigning compliant, complete, and accurate ICD-10-CM diagnosis codes and CPT service codes for the professional component of rendered services based upon the clinical documentation provided within the medical record. The role works collaboratively with other members of the Coding, Coding Quality and Clinician Education team to complete all essential responsibilities in a timely fashion to meet the quality, utilization, and financial needs of the organization.

Responsibilities

• Examine medical records to determine the proper ICD (diagnosis) and CPT (procedure codes) to be assigned
• Utilize coding tools & resources to verify the correctness of CPT and ICD codes assigned
• Abstract data including providers, injury info, quality measures, and others as needed
• Maintain knowledge of current trends and practices in coding principles and government regulations through reading materials and/or attendance at educational meetings or seminars
• Maintain appropriate certification
• Communicate with coworkers and physicians to resolve and clarify questions and documentation discrepancies
• Communicate risk management concerns to appropriate parties
• Complete priority accounts (Holds) daily
• Refers complex issues to designated work queues
• Participates in coder specific training and education based on audit metrics and trends
• Review and analyze content of medical record to accurately assign ICD diagnosis and procedure codes; CPT procedure codes and modifiers according to national coding guidelines, USACS policies and SOPs
• Answer coding and abstracting questions from coding leadership, compliance, clinicians, etc.
• Maintain coding accuracy rate of ≥ 95%
• Maintain coding productivity (Milestone based standards) rate of ≥ 95%
• Maintain minimum of 15 CEUs per quarter either through Nthrive and/or other company sponsored webinars and programs
• Accurately identify and enter core abstracting elements such as physician and APP attributions
• Identify documentation trends and topics for education/feedback to physicians and APPs
• Keep current with coding and industry changes through participation in educational opportunities
• Thorough understanding of updates from intermediaries, carriers, government agencies, third party payers to ensure proper documentation, coding and compliance
• Thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payor specific guidelines
• Assists with special projects as needed and performs related duties as assigned

Requirements

• High school diploma or equivalent
• One or more of the following credentials are required prior to hire date - Certified Coding Specialist (CCS), Certified Professional Coder (CPC-A), Certified Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist – Physician-Based (CCS-P)

Skills and Abilities

• Knowledge of and experience using ICD and CPT coding
• Knowledge of payor guidelines
• Knowledge of and skill in using personal computers in a Windows environment with an emphasis on basic word processing and data entry
• Ability to work independently and make decisions
• Ability to pay close attention to detail
• Ability to identify research and solve problems and discrepancies
• Ability to communicate with employees, management and physicians in a courteous and professional manner
• Ability to maintain confidentiality
• Ability to process assigned duties in an organized manner

Benefits

• Medical, dental, and vision insurance options
• Health savings accounts (HSA) and flexible spending accounts (FSA)
• 401(k) employee and employer contributions
• Paid time off, including vacation, sick leave, and company holidays
• Paid parental leave & family support benefits
• Short-term and long-term disability insurance
• Life and accidental death & dismemberment (AD&D) insurance
• Employee assistance programs & wellness resources

Pay

Hourly Rate: $18.76 - $34.70

Schedule

Hourly rate may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description.