Coding Specialist III, Professional Billing

Major Responsibilities

• Distributes and monitors the flow of work for coding staff.
• Provides training and technical assistance to employees within the assigned work area.
• Aids supervisor in ensuring that assigned employees are provided with appropriate resources, materials, and methods.
• Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel.
• Relays work instruction from the supervisor.
• Reviews coded records for coding quality assurance.
• Provides instruction and feedback to coding staff regarding proper coding assignment as necessary.
• Acts as a point person/department resource for special projects/programs and responds to coding related questions and issues.
• Affords assistance in MD, Resident and Nursing documentation reviews, audits, and educational sessions as applicable.
• Performs analysis on medical record documentation to include review of tests/reports, and determines appropriate codes, as defined by coding guidelines and other recognized reference materials.
• Abstracts and enters all codes and required demographic information into the UMMHC computer system and/or onto encounter forms.
• Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.
• Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.
• Participates in quality assurance and performance measurement reviews and reporting.
• Communicates to supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.
• Informs management of any coding irregularities or trends contrary to policy or procedure, and communicates with clinical staff if necessary and appropriate.
• Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.

Position Qualifications

• High School education, plus medical coding certification and training in medical terminology from an accredited program.
• Recognized programs include: AHIMA, NHA, and AAPC.
• Five years of medical abstraction and coding experience or related work experience.
• Knowledge of ICD-CM (current edition) and CPT HCPCS coding systems, 3rd party payer requirements and federal/state guidelines and regulations pertaining to coding and billing practices.
• The ability to lead, organize, and support the work of less senior Coding Specialists is a primary function of this position.
• Requires good interpersonal and communications skills and maintains a professional manner when working with team members, management and other staff members.
• Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word.