Hospital Coding Specialist I

Category: Admin Support City: Jackson State: Tennessee Shift: 8 - Day (United States of America) Job Description Summary: The Hospital Coding Specialist I is responsible for the coding and optimization of electronic medical records. Incumbent is responsible for assigned 8-hour shift, 5 days a week. Employee is subject to call back and overtime as required by the hospital. ESSENTIAL JOB FUNCTIONS: Strongly knowledgeable of the ICD-10 Official Guidelines for Coding and Reporting provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) and the American Medical Association (AMA) CPT Coding Guidelines. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association. Reviews electronic medical records and identifies all treated diagnoses and significant procedures performed. Uses coding software to assign ICD-10-CM diagnosis and CPT procedure codes and modifiers when indicated, to ensure coding and APC accuracy. Sequences diagnosis codes according to the definition of primary diagnosis and other co-morbid conditions and complications. Sequences procedure codes according to the definition of primary procedure and other procedures. Utilizes online coding references, CMS Local Coverage Determinations (LCDs), and other payor guidelines to ensure appropriate code assignment for Compliance, Billing, and Medical Necessity. Ensures all diagnosis, CPT procedure codes and modifiers, procedure dates, and surgeons are accurately transferred from the coding software to the coding and billing application. Identifies and communicates documentation opportunities relative to appropriate coding assignment. Completes physician queries as indicated for clarification of documentation. Utilizes abstracting application to enter and /or update Consulting Physicians, Discharge Dispositions, and Attending Physician. Reviews and responds to internal and external coding audits in a timely manner. Reviews and resolves coding and reimbursement related denials and edits to ensure timely submission of claims. Remains informed of continual changes in coding and billing and maintains compliance with federal, state and hospital policies. Completes all assigned online training and education activities timely and attends all required onsite meetings. Responds to to e-mails and requests from Supervisor, Manager and other hospital employees in a professional and timely manner. Consistently meets required productivity and accuracy standards. Responsible for maintaining coding certification. Performs related responsibilities as required or directed. JOB SPECIFICATIONS: EDUCATION: Skill and proficiency in diagnosis and procedure coding, and other principles, concepts and techniques of Health Information Management. Such proficiency is acquired through either an RHIA, RHIT, CCS, or CCA credential or a program accredited by AHIMA LICENSURE, REGISTRATION, CERTIFICATION: Current certification as RHIA, RHIT, CCS or CCA by AHIMA or obtained within the first year of employment EXPERIENCE: Knowledge of Health Information Management practices, coding and coding guidelines, as acquired through RHIA, RHIT, CCS or CCA certification. Experience in coding diagnostic outpatients, emergency department records, ancillary outpatients or physician office coding required. Should be able to code a minimum of 125 diagnostic outpatients, 100 ancillary outpatients, and 90 emergency room records per day by the end of the three-month training period. KNOWLEDGE, SKILLS AND ABILITIES: Extensive knowledge of computer applications (Microsoft Windows, computerized equipment, etc.,) a must. Ability to navigate through the computer (software and hardware) and recognize potential issues. NONDISCRIMINATION NOTICE STATEMENT We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.