Job Summary:
The Coding Specialist reviews, analyzes, and abstracts health records to identify relevant diagnoses and procedures for distinct patient encounters.
Primary Responsibilities:
- Review medical documentation for accuracy and compliance with inpatient and outpatient coding and coverage rules
- Review medical record documentation and accurately code the primary and all applicable secondary diagnoses and procedures using ICD-9-CM, CPT, and HCPCS coding conventions
- Based on codes assigned, determine Diagnosis-Related Groups (DRGs) and Hierarchical Condition Categories (HCCs)
- Strong knowledge of privacy regulations, medical record practices, and Medicare and Medicaid regulations
- Document coding decisions using electronic review tracking systems
- Participate in and contribute to the quality management system
Knowledge and Skill Requirements:
- Professional Coder designation: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC)
- 2 years general acute hospital and physician medical record coding experience applying ICD-9-CM, CPT, and HCPCS coding guidelines for inpatient and outpatient settings
- Knowledge of Medicare and Medicaid billing rules
- Outstanding verbal and written communication skills
- Knowledge of medical terminology, anatomy, and physiology
- Proficient in Microsoft Office, Internet and email
Working Conditions:
- Office environment
- Ability to sit and work at computer for an extended period of time
- Ability to lift and/or move up to 35 lbs.