Coding Specialist Certified

Mount Nittany Health•Bellefonte, PA

About The Position

The Coding Specialist Certified is responsible for searching a patient's entire medical record to ensure comprehensive coding and abstracting utilizing coding rules, principles, and ethics under the supervision of the Coding Supervisor and Manager, Health Information Management. With quality and reimbursement contingent upon coding, it is the responsibility of the Medical Center Coding Specialist Certified to have knowledge of DRG methodology, ICD-10, CPT-4, and APC coding rules and principles.

Requirements

Graduate of an approved Health Information Management Technology program, preferred.
Must have Registered Health Information Technician (RHIT) credentials, Certified Coding Specialist (CCS) or other relevant credentials such as Certified Professional Coder (CPC) or one year of relevant experience.
If does not have credentials, must obtain the required credentials within 1 year of hire/transfer.
Graduate of Medical Office Specialist program with current, acute care experience with ICD-10, CPT, DRG coding rules and methodologies required.
Must have Certified Coding Specialist (CCS) or other relevant credential or one year of relevant experience.
If does not have credentials, must obtain the required credentials within 1 year of hire/transfer.
Current, acute care experience with ICD-10, CPT, DRG, APC coding rules and methodologies preferred.
Demonstrates knowledge of diagnostic and procedural terminology, medical terminology and disease processes (anatomy and physiology).
Self-motivated individual with personal integrity to organize work and work independently.
Typing skills with basic knowledge of computer operations.
Communication skills necessary to approach the medical staff, hospital personnel, ancillary department etc. for any clarifications regarding record questions or problems utilizing coding rules and principles.
Registered Health Information Technician (RHIT) and/or Certified Coding Specialist (CCS) and/or Certified Professional Coder (CPC) are required within 1 year of hire/transfer.

Nice To Haves

Graduate of an approved Health Information Management Technology program.
Current, acute care experience with ICD-10, CPT, DRG, APC coding rules and methodologies.

Responsibilities

Reviews the medical record for diagnoses and procedures performed.
Identifies and sequences principal diagnosis, secondary diagnoses, principal procedures, complications, and comorbid conditions, for optimal reimbursement, utilizing proper coding practices.
Assigns proper ICD-10, CPT-4, DRG codes for all diagnoses, procedures, complications, and comorbid conditions during the course of hospitalization after researching the entire record, maintaining a 95% accuracy rate.
Performs duties involving abstracting information from the medical record and entering the information into the in-house computer systems and interfaces.
Data enters accurate ICD-10 and CPT-4 codes, physician related and clinical information, and demographic information into computerized coding/abstracting system, in accordance with established procedures, maintaining a 95% accuracy rate.
Assigns DRG and electronically releases accounts for generation of a patient bill after physician completion, as required.
Processes and follows through with clinical codes and diagnostic information as records are returned by physicians, in accordance with established procedures.
Enters charges on Emergency Department medical record based on procedure coding, according to rules applied by each payer.
May work with the Clinical Documentation Specialists.
May complete Radiology and/or Medical Necessity worklists.
Meets standard of performance for coding (trainee and experienced levels).
Coordinates outpatient coding for Medicare, Blue Cross, Medical Assistance, HMO’s, and Commercial Insurance accounts.
Reviews registration information at the time of coding for accuracy.
Enters coding into the system in preparation for electronic and hardcopy claims submissions following HIPAA guidelines.
Processes incomplete records by forwarding incomplete and/or invalid records to physician, and/or clarifying concerns regarding the record with the physician, as required.
Assists in chart completion utilizing computerized system and following established departmental procedures.
Maintains timely completion of records by expediting the completion of the abstracting procedure to generate the patient bill in a timely manner.
Assists with facilitation of timely and accurate chart completion and processing.
Performs coding/abstracting utilizing electronic records according to procedure.
Remains current in coding rules and practices by reviewing current literature and acquiring reference material to enhance knowledge regarding diagnostic and procedural terminology.
Remains current in coding practices through reading, attendance of in-service programs, and designated continuing educational programs, as required for up to date practices.
Participates as a team member to the organization.
Maintains liaison with medical staff, hospital personnel, patients, other hospitals, and clinics, as required.
Assists with orientation and ongoing training of new/other employees to specific coding job functions at a level that employee can accomplish, as assigned.
Practices excellent communication skills by receiving and recording initial contacts on the telephone or via computer; courteously assisting callers; answering incoming telephone calls, taking messages, providing information or routing calls to appropriate individual; answering incoming emails, providing information or directing to appropriate office or individual.
Performs related and miscellaneous duties as assigned.
Accepts additional assignments as required from supervisory personnel meeting any specific time frame indicated.
Assists supervisory personnel in any task oriented job function to maintain effective, timely chart flow and expedite cash flow, as needed.
Assists with proficiency/competency reviews as assigned.