Lead, Coding Specialist

Responsibilities

• Credits ad hoc coding quality reviews to ensure coding quality of the department.
• Identifies coder trend opportunities from internal and external audits and advises coding manager of identified trends/patterns and facilitates action plan for improvement.
• Coaches other coders by training, educating, and advising on coding and abstracting according to ICD-10-CM/PCS conventions and guidelines, responding to coding inquiries, reviewing and noting coded charts, providing feedback, and monitoring chart corrections to ensure that noted changes have been made to facilitate coding consistency, accuracy, efficiency, and appropriate billing and reimbursement.
• Contributes with workflow, priorities for work completion, and communicates workflow issues to the supervisor. Identifies ways to improve work processes and improve customer satisfaction.
• Sets appropriate principal and secondary diagnosis and procedures codes for all episodes of care on inpatient encounters ensuring appropriate DRG assignment according to ICD-10-CM/PCS conventions, guidelines, and hospital policy.
• Achieves and maintains 95% accuracy on quality reviews and meets assigned productivity standards.
• Abstracts statistical data from the medical record and enters information according to Parkland's guidelines, policies, and procedures.
• Demonstrates knowledge of billing and coding requirements for governmental guidelines and private insurance payers. Verifies, edits, and/or enters charges based on documentation or insurance requirements reporting any discrepancies in a timely manner.
• Collaborates with physicians and nurses by telephone or in writing to clarify or complete records by obtaining missing diagnoses, procedures, or information, resolving ambiguous coding episodes to ensure that missing information is corrected and resubmitted for payment.

Qualifications

• Education: High school diploma required. Must have successfully completed an approved coding program or be a graduate of a Health Information Management program.
• Experience: Four (4) years of coding experience in a combination of acute care hospital and clinic professional environment.
• Other: Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to provide proof of renewal. Although an additional seven (7) calendar days is allowed to provide proof of renewal, there cannot be a lapse in the certification's 'active' status. Must be certified through the American Health Information Management Association 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) or certified through the American Association of Procedural Coders (AAPC) as one of the following: Certified Professional Coder (CPC), Certified Inpatient Coder (CIC).