Coding Quality Assur Spec III
About The Position
This role involves assigning ICD-10-CM, ICD-10-PCS, and/or CPT codes by reviewing and interpreting physician documentation. The specialist will communicate with the education team and/or providers, review patient charges, and identify principle and secondary diagnoses and procedure codes from the electronic medical record. They will utilize encoders or coding books, sequence diagnoses and procedures for appropriate billing, and query physicians for clarification when needed. The role also involves using various resources like Epic, MIQS, Cardio IMS, and coding reference materials, assisting other coders, providing coding for research and quality reporting, completing abstracts, correcting problem accounts, reviewing charts for completeness, participating in education, maintaining certification, assisting in audits, and maintaining concurrent coding for inpatient records.
Requirements
- H.S. Diploma or equivalent
- CCA - Certified Coding Associate by the American Academy of Professional Coders (AAPC)
- CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)
- CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)
- CIPC - Certified Inpatient Coder by the American Academy of Professional Coders (AAPC)
- COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)
- CPC - Cert-Cert Professional Coder by the by the American Academy of Professional Coders (AAPC)
- CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC)
- RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)
- RHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)
- 4 years coding experience
- Experience using an encoder
- Experience using an electronic medical record
Responsibilities
- Assigns ICD-10-CM, ICD-10-PCS, and/or CPT codes.
- Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.
- Communicates with and provides feedback to the education team and/or providers.
- Reviews patient charges to determine necessary coding to complete the account.
- Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.
- Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
- Sequences diagnosis and procedures to generate appropriate billing.
- Queries physicians to obtain diagnosis if not clearly provided in records.
- Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, and coding reference materials).
- Assists other coders in resolving coding problems.
- Provides ICD-10 and CPT, for physician research projects, and for quality reporting purposes.
- Completes abstracts for records as appropriate.
- Assists in correction of problem accounts.
- Reviews charts for completeness.
- Participates in education and maintains certification.
- Assists in auditing records.
- Maintains concurrent coding for inpatient records.
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What This Job Offers
Career Level
Senior
Education Level
High school or GED
