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 use by Patient Financial Services for submitting patient's bills.

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 personnel 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 of 95% coding accuracy while meeting or exceeding productivity standards set forth by the department leadership.

10. Abides by the Code of Ethics and the Standards of Ethical Coding as set forth by the American Health Information Association (AHIMA) and adheres to Official Coding Guidelines.

11. Adheres to relevant policies, procedures, regulations and expectations of Bryan Health. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

12. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

13. Participates in meetings, committees and department projects as assigned.

14. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk “*”).

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of anatomy, physiology, pharmaceuticals, medical terminology, disease process and ICD-10 and CPT Coding.

2. Knowledge of computer hardware equipment and software applications relevant to work functions.

3. Ability to meet high standards of work accuracy and productivity.

4. Ability to prioritize work and seek assistance when appropriate.

5. Ability to communicate effectively both verbally and in writing.

6. Ability to perform crucial conversations with desired outcomes.

7. Ability to establish and maintain effective working relationships with all levels of personnel and medical staff.

8. Ability to problem solve and engage independent critical thinking skills.

9. Ability to maintain confidentiality relevant to sensitive information.

10. Ability to prioritize work demands and work with minimal supervision.

11. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Class work in ICD-10-CM and CPT Coding procedures required. Certification as a Certified Coding Specialist - Professional (CCS-P) or Certified Professional Coder (CPC) required. Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) preferred. Minimum of one (1) year facility coding experience in a medical environment required.

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT) – Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.