Coding Specialist

Prairie Lakes Healthcare System•Watertown, SD

21h•$21 - $31•Hybrid

About The Position

Join our team and be a part of our mission to deliver accessible, high-quality, affordable, and compassionate healthcare. Prairie Lakes Healthcare System is an independent, non-profit healthcare system serving 10 counties in northeastern South Dakota and west-central Minnesota. Our team at Prairie Lakes makes a difference in the lives of patients and their loved ones. This full-time position (40 hours per week) assigns ICD-10-CM and CPT/HCPCS codes and releases medical records for billing purposes. Works with Clinical Documentation Specialist to provide proper documentation to obtain the proper DRG. Maintains compliance with federal and state guidelines.

Requirements

Associate's Degree or Bachelor's Degree in Health Information Management.
Coding experience or a strong training background in coding and reimbursement is preferred.
Microsoft applications, CPSI, 3M Encoder

Nice To Haves

RHIT/RHIA or any AAPC certification preferred.
RHIT, RHIA, CCS, and/or CCS-P certification status preferred.
Coding certification preferred by the American Health Information Management Association.

Responsibilities

Abstracts pertinent information from patient records assigning ICD-10-CM or HCPCS codes, creating APC or DRG group assignments.
Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
Key charges for surgery, anesthesia, infusion services, Evaluation and Management levels for the emergency room and observation patients and clinic. Along with any additional required procedures.
Answer questions for the Reimbursement Department and Quality Department.
Assign Emergency and Management levels for Professional Fees.
Monitors the NCCI edit report and communicates with the applicable departments to resolve the edits to have a clean claim be billed to Medicare.
Monitor NCD/LCD policies for medical necessity on outpatient and surgical claims.
Assist with creation of new service lines for CPT/HCPCs/APC and DRG reimbursement.
Keeps abreast of coding guidelines and reimbursement reporting requirements, bringing identified concerns to supervisor or department manager for resolution.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official guidelines.
Other duties may be assigned.