Coding Specialist I – Inpatient Medicine

Role Overview

• Examines medical records to determine the proper ICD (diagnosis) and CPT (procedure codes) to be assigned
• Utilizes coding tools & resources to verify the correctness of CPT and ICD codes assigned
• Abstracts data including providers, injury info, quality measures, and others as needed
• Maintains knowledge of current trends and practices in coding principles and government regulations through reading materials and/or attendance at educational meetings or seminars
• Maintains appropriate certification
• Communicates with coworkers and physicians to resolve and clarify questions and documentation discrepancies
• Communicates risk management concerns to appropriate parties
• Completes priority accounts (Holds) daily
• Refers complex issues to designated work queues
• Participates in coder specific training and education based on audit metrics and trends
• Review and analyze content of medical record to accurately assign ICD diagnosis and procedure codes; CPT procedure codes and modifiers according to national coding guidelines, USACS policies and SOPs
• Answer coding and abstracting questions from coding leadership, compliance, clinicians, etc.
• Maintain coding accuracy rate of ≥ 95%
• Maintain coding productivity (Milestone based standards) rate of ≥ 95%
• Maintain minimum of 15 CEUs per quarter either through Nthrive and/or other company sponsored webinars and programs
• Accurately identify and enter core abstracting elements such as physician and APP attributions
• Identify documentation trends and topics for education/feedback to physicians and APPs
• Keep current with coding and industry changes through participation in educational opportunities
• Thorough understanding of updates from intermediaries, carriers, government agencies, third party payers to ensure proper documentation, coding and compliance
• Thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payor specific guidelines
• Assists with special projects as needed and performs related duties as assigned

Requirements

• High school diploma or equivalent
• One or more of the following credentials are required prior to hire date
• Certified Coding Specialist (CCS), Certified Professional Coder (CPC-A), Certified Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist – Physician-Based (CCS-P)
• Knowledge of and experience using ICD and CPT coding
• Knowledge of payor guidelines
• Knowledge of and skill in using personal computers in a Windows environment with an emphasis on basic word processing and data entry
• Ability to work independently and make decisions
• Ability to pay close attention to detail
• Ability to identify research and solve problems and discrepancies
• Ability to communicate with employees, management and physicians in a courteous and professional manner
• Ability to maintain confidentiality
• Ability to process assigned duties in an organized manner

Benefits

• Medical, dental, and vision insurance options
• Health savings accounts (HSA) and flexible spending accounts (FSA)
• 401(k) employee and employer contributions
• Paid time off, including vacation, sick leave, and company holidays
• Paid parental leave & family support benefits
• Short-term and long-term disability insurance
• Life and accidental death & dismemberment (AD&D) insurance
• Employee assistance programs & wellness resources
• Additional compensation may include bonus eligibility, equity, or other incentive programs