Coding Specialist II

About the role

The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on various departments within the hospital.

Responsibilities

• Code, abstract and conduct charge quality review on all episodes of care on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS) and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines and hospital policy.
• Analyze questionable documentation to ensure the accuracy of information and resolve identified issues.
• Assigns appropriate diagnosis and procedures codes utilizing ICD 10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to CMS requirements for both professional and hospital billing.
• May assist in training and reviewing the work of other coders for accuracy and efficiency.
• Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
• Verify, edit and/or enter charges based on documentation or payer/billing requirements, reporting any discrepancies in a timely manner.
• Updates patient database with classification codes and resolves conflicts or inconsistencies to provide sufficient patient health information according to Parkland's standards.
• Stays abreast of the latest developments, advancements, and trends in the field of health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrating knowledge gained into current work practices.
• Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
• Facilitate a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work related encounters are productive.
• Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the Coding area.
• Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans.
• Seeks advice and guidance as needed to ensure proper understanding.

Requirements

• High school diploma required.
• Must have successfully completed an approved coding program OR be a graduate of a health Information Management program.
• Strong knowledge of Anatomy and Physiology and possess strong application skills.
• Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties.
• Physician office coding, charging, and billing experience preferred.

Qualifications

• Education: High school diploma required.
• Certification/Registration/Licensure: Certified through the American Health Information Management Association (AHIMA) as one of the following: Registered Health Information Management Technician (RHIT), Registered Health Information Management Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Coding Associate (CCA); or certified through the American Association of Procedural Coders (AAPC) as one of the following: Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), Certified Outpatient Coder (COC).
• Experience: Two (2) years of coding experience in an acute care setting or diverse clinical specialties. Physician office coding, charging, and billing experience preferred.
• Tests: Score a minimum of 80% on a pre-employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.

Skills

• Advance coding and charge review skills, understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations.
• Advanced knowledge of ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage for hospital and professional billing.
• Knowledge of medical terminology, the human disease process, anatomy and physiology.
• Proficiency in coding and encoder skills.
• Knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC).
• Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.

Pay

Details about pay are not specified in the job posting.

Schedule

The position is 100% Virtual. Virtual employees must also comply with all Parkland policies and procedures governing the use of Parkland information resources. Virtual employees must maintain all equipment lent by Parkland for performing the agreed upon job duties in good working condition. All employment responsibilities and conditions in applicable Parkland policies and procedures apply to employees while working virtually.