Coding Specialist II

Job Overview

This position abstract codes provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Provides coding expertise to department management, coding staff, clinical staff, and billing staff. Meets or exceeds departmental standard related to quality and productivity.

Job Responsibilities

• Assists with coding/billing questions from both internal and external customers.
  • Which will include follow-up on denials, research, and review of charts for potential coding issues.
• Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary.
• Communicate with other clinical staff regarding documentation trends.
• Maintain a close working relationship with all departments and internal customers including leadership and consolidates efforts to ensure appropriate and standardized coding procedures are followed.
• Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources.
• Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems.
• Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes.
• Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable.
• Ensure that all codes are current, active, and billable according to CCI.

Other Job-related Information

• Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]) PMI (Certified Medical Coder [CMC]) AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT])

Working Conditions

• Climbing - Rarely
• Concentrating - Consistently
• Continuous Learning - Consistently
• Hearing: Conversation - Consistently
• Hearing: Other Sounds - Frequently
• Interpersonal Communication - Consistently
• Kneeling - Rarely
• Lifting
• Lifting 50+ Lbs - Rarely
• Lifting 11-50 Lbs - Rarely
• Pulling - Rarely
• Pushing - Rarely
• Reaching - Rarely
• Reading - Consistently
• Sitting - Consistently
• Standing - Frequently
• Stooping - Rarely
• Talking - Frequently
• Thinking/Reasoning - Consistently
• Using Hands - Occasionally
• Use of Hands - Occasionally
• Color Vision - Rarely
• Visual Acuity: Far - Frequently
• Visual Acuity: Near - Frequently
• Walking - Occasionally

TriHealth SERVE Standards and ALWAYS Behaviors

• Welcome everyone by making eye contact, greeting with a smile, and saying "hello."
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist.
• Refrain from using cell phones for personal reasons in public spaces or patient care areas.
• Excel: ALWAYS… Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met.
• Offer patients and guests priority when waiting (lines, elevators).
• Work on improving quality, safety, and service.
• Respect: ALWAYS… Respect cultural and spiritual differences and honor individual preferences. Respect everyone’s opinion and contribution, regardless of title/role. Speak positively about my team members and other departments in front of patients and guests.
• Value: ALWAYS… Value the time of others by striving to be on time, prepared and actively participating. Pick up trash, ensuring the physical environment is clean and safe. Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
• Engage: ALWAYS… Acknowledge wins and frequently thank team members and others for contributions. Show courtesy and compassion with customers, team members and the community.