About this role
Role Overview
- Review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement.
- Validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals.
- Perform documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements.
- Interact with client staff and providers.
- Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management.
- Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record.
- Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
- Complete assigned work functions utilizing appropriate resources.
- May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
- Maintain strict patient and provider confidentiality in compliance with all HIPAA Guidelines.
- Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
- Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
- Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
Requirements
- An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
- Two years of recent and relevant hands-on coding experience
- Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets
- Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards
- Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files, (Outlook, Word, Excel)
- Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers
- Recent and relevant experience in an active production coding environment strongly preferred
- Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience
- Experience using RCX, Cerner, Nextgen (a plus)