Coding Specialist II

Possesses the knowledge and skills to thoroughly review the clinical content of outpatient, therapy/recurring series, specialty clinic, emergency department/emergency charge capture, outpatient surgery, observation and simple inpatient medical records and assign appropriate ICD-10-CM codes to diagnosis and CPT and HCPCS codes to all procedures or physician services for optimal reimbursement.

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Studies and analyzes the clinical content of a medical record.

3. *Assigns and sequences diagnosis and procedure codes appropriately to arrive at the correct DRG or APC assignment.

4. *Enters coding information into the computer system for reimbursement purposes for submitting patient's claims.

5. *Maintains a thorough and updated knowledge of Clinical Coding Guidelines, Fiscal Intermediary directives, Coding Compliance standards and Local Medical Review Policies.

6. *Instructs other hospital staff on appropriate medical necessity needed for coding accurately.

7. Assists with peer review auditing activities for accuracy and compliance.

8. *Maintains strict confidentiality regarding patient information.

9. *Works as a team member to ensure that all coding types meet or exceed the established quality standard coding accuracy while meeting or exceeding productivity standards set forth by the department leadership.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Coursework in ICD-10-CM and CPT Coding procedures required. Minimum of one (1) year facility coding experience in a medical environment required.

OTHER CREDENTIALS / CERTIFICATIONS:

Certification as a Certified Coding Specialist - Professional (CCS-P), Certified Professional Coder (CPC), Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) required.