Coding Specialist II

Parkland Health

51d•Remote

About The Position

The Coding Specialist II is responsible for coding and verifying charge data to ensure correct coding, abstracting, and billing for various patient encounters including emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics, and inpatient OB/newborn. This role also involves charge review for accurate professional charging and billing. The position requires proficiency in ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M, and modifier codes. Additionally, the specialist will provide direction to coding staff regarding coding integrity, guidelines, and Parkland’s policies to ensure accuracy and appropriate reimbursement. This position is 100% virtual and requires the employee to maintain equipment lent by Parkland in good working condition and comply with all Parkland policies and procedures.

Requirements

High school diploma required.
Must have successfully completed an approved coding program.
OR Must be a graduate of a health Information Management program.
Must have strong knowledge of Anatomy and Physiology and possess strong application skills.
OR Must be CCS Certified
Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties.
Must be certified through the American Health Information Management Association (AHIMA) as one of the following: Registered Health Information Management Technician (RHIT), Registered Health Information Management Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS-P), Certified Coding Associate (CCA) certification.
OR Must be certified through the American Association of Procedural Coders (AAPC) as one of the following: Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), Certified Outpatient Coder (COC).
Score a minimum of 80% on a pre-employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
Advance coding and charge review skills understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations.
Advanced knowledge of ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage for hospital and professional billing.
Must have knowledge of medical terminology, the human disease process, anatomy and physiology.
Demonstrate proficiency in coding and encoder skills.
Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC).

Nice To Haves

Physician office coding, charging, and billing experience preferred.
Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.

Responsibilities

Code, abstract, and conduct charge quality review on all episodes of care for emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines, and hospital policy, analyzing questionable documentation to ensure accuracy and resolving identified issues.
Assign appropriate diagnosis and procedure codes utilizing ICD 10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to CMS requirements for both professional and hospital billing.
May assist in training and reviewing the work of other coders for accuracy and efficiency.
Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
May verify, edit, and/or enter charges based on documentation or payer/billing requirements, reporting any discrepancies in a timely manner.
Update patient database with classification codes and resolve conflicts or inconsistencies to provide sufficient patient health information according to Parkland’s standards.
Stay abreast of the latest developments, advancements, and trends in health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrating knowledge gained into current work practices.
Identify ways to improve work processes and customer satisfaction, making recommendations to supervisor, implementing, and monitoring results as appropriate.
Facilitate a positive working relationship with physicians, nurses, medical staff, and hospital employees to ensure productive work-related encounters.
Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines impacting the Coding area, developing effective internal controls to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans, seeking advice and guidance as needed.
Maintain CE hours and renew annual coding credentials.