Coding Specialist I

GENERAL SUMMARY:

Possesses the knowledge and skills to thoroughly review the clinical content of Outpatient, Emergency Department and/or Therapy/Recurring Series medical records to assign appropriate ICD-10-CM codes to diagnosis procedures and CPT and HCPCS codes to all procedures or physician services for optimal reimbursement.

PRINCIPAL JOB FUNCTIONS:

• Commits to the mission, vision, beliefs and consistently demonstrates our core values.
• Studies and analyzes the clinical content of a medical record.
• Accurately completes coding of diagnosis, assigns CPT and HCPCS codes and enters physician clinic charges within established timeframes.
• Accurately completes coding of diagnosis, procedures, and assigns CPT and HCPCS codes on hospital services within established timeframes.
• Enters coding information into the computer system for reimbursement use by Patient Financial Services for submitting patient's bills.
• Queries physicians appropriately as needed when the documentation is not clear and follows up on queries.
• Works as a team member to ensure all coding is accurate and meets turnaround standards.
• Performs established and special project coding audits.
• Assists medical providers and ancillary staff with coding information needed for prior authorizations and insurance billing follow-up.
• Assists Meaningful Use and Quality reporting initiatives by participation in projects.
• Assists with establishment and maintenance of CAMC coding guidelines.*Maintains strict confidentiality regarding patient information and office issues.
• Abides by the Code of Ethics and the Standards for Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all Official Coding Guidelines.
• Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
• Participates in meetings, committees and department projects as assigned.
• Performs other related projects and duties as assigned.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Class work in ICD-10-CM, CPT Coding, and related courses from an accredited college or acceptable program required. Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) credential preferred. Prior coding experience in a medical environment preferred.