Professional Coding Specialist II-(Interventional Radiology)

About the role

Reviews all surgical documentation to assign accurate ICD-10, CPT, HCPCS codes, and modifiers for complex procedures performed throughout WVU Medicine. Complies with national coding guidelines to ensure that all procedures are coded accurately and consistently. Applies coding conventions and rules established by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) when assigning procedural, diagnostic, and HCPCS codes to ensure compliance with CCI edits, MUE edits, LCD, and NCDs. Collaborates with appropriate personnel to address documentation insufficiencies and expedite resolution of accounts.

This position can work remotely from anywhere in the United States.

Responsibilities

• Accurately codes and/or audits complex surgical procedures as part of daily workload (85%-95% of workload), including but not limited to:
  • Bariatric surgery
  • Cardiothoracic surgery
  • Gynecologic surgery
  • Oncology surgery
  • Orthopaedics surgery
  • Thoracic surgery
  • Transplant surgery
  • Trauma and burn surgery
  • Open Vascular surgery
• Reviews and accurately interprets medical record documentation to identify all diagnoses and procedures affecting the current inpatient stay or outpatient encounter, assigning appropriate ICD-10, CPT, or modifier codes.
• Ensures quality and timely coding, charging, and abstraction of accounts are completed daily for assigned specialty areas.
• Maintains and enhances current coding knowledge through quality reviews, attendance at clinical in-services and coding seminars, internal meetings, and study of reference materials.
• Ensures accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or other personnel to obtain information required for accurate coding assignments.
• Works and communicates with other offices to facilitate the billing process.
• Monitors provider documentation on an ongoing basis and performs audits to assess provider coding accuracy, following up with provider education as needed.
• Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts.
• Analyzes and resolves issues of missing charges and problem accounts by researching department reimbursement information.
• Interacts with physician and non-physician providers to maximize correct coding initiatives.
• Maintains expertise and expanding knowledge in coding and sequencing guidelines to ensure accurate assignment of healthcare information.

Requirements

• High School Diploma or Equivalent.
• Current HIM/Coding Certification through one of the following:
  • American Health Information Management Association (AHIMA)
  • American Academy of Professional Coders (AAPC)
• Must obtain Specialty Medical Coding Certification through the American Academy of Professional Coders (AAPC) within one (1) year of hire.
• Three (3) years of medical coding experience, including one (1) year of advanced surgical coding experience.

Preferred Qualifications

• Associate’s degree in Health Information Management.
• Four (4) years of coding experience.

Skills

• Ability to concentrate and maintain accuracy during constant interruptions.
• Independent decision-making ability.
• Ability to prioritize job duties.
• Ability to handle high-stress situations.
• Adaptability to changes in the workplace.
• Ability to organize and complete assigned tasks.
• Excellent written and verbal communication skills.
• Must meet quality and productivity standards.
• Knowledge of anatomy, physiology, and medical terminology.

Physical Requirements

• Must be able to sit for long periods of time.
• Must have visual and hearing acuity within the normal range.
• Must have manual dexterity needed to operate computer and office equipment.
• Able to lift, push, or pull 10-20 pounds.

Working Environment

• Standard office environment.
• Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.
• May require occasional travel.

Schedule

Scheduled Weekly Hours: 40

Shift: Day (United States of America)

Exempt/Non-Exempt: Non-Exempt