HIM Coding Specialist
About The Position
The HIM Coding Specialist performs accurate and timely coding and abstracting for inpatient and outpatient medical records to optimize reimbursement for all payer classes. The role includes working billing edits in the EMR and claim scrubber and is normally scheduled Monday through Friday. The specialist analyzes patient records and assigns appropriate diagnosis and procedure codes, abstracts required data, enters codes promptly, and helps ensure accurate reimbursement, data collection, and clinical data analysis. The role reviews charges, identifies additional charges needed for billing accuracy, and collaborates with physicians and clinical team members to clarify diagnoses, procedures, and documentation. It also requires maintaining coding quality and productivity, prioritizing work to meet turnaround requirements, and following applicable medical-record, HIPAA, safety, and compliance requirements. The position supports the hospital’s Mission, Vision, and Values; participates in Health Information Management meetings as directed; uses coding reference materials, including coding books and the 3M encoder; and may assist with orienting and training new staff. Other duties may be assigned and are subject to change.
Requirements
- High school diploma or equivalency, with college courses in medical terminology, anatomy, and coding.
- Minimum of 1 year of experience in the medical coding field.
- Knowledge of reimbursement systems and Medicare regulations.
- Excellent customer service skills.
- Coding certification through AAPC or AHIMA.
Responsibilities
- Support and promote an environment conducive to the hospital’s Mission, Vision, and Values.
- Analyze patient records for principal and secondary diagnoses and procedures, and assign appropriate codes according to established guidelines.
- Maintain current knowledge of HIPAA and best practices regarding medical records.
- Abstract required data for patient records.
- Enter codes in a timely manner.
- Facilitate the flow of medical-record data to support accurate and prompt reimbursement, data collection, and clinical data analysis.
- Represent Health Information Management as a team member and attend meetings as directed.
- Review assigned charges for accuracy and validity.
- Assign additional charges needed for billing accuracy.
- Collaborate with physicians regarding diagnoses and procedures to ensure accuracy.
- Follow up with providers when documentation is insufficient or unclear.
- Ensure documentation meets medical necessity guidelines.
- Organize and prioritize assigned work and schedule time to meet work demands and turnaround requirements.
- Maintain coding productivity and quality.
- Recognize, interpret, and evaluate inconsistencies and discrepancies in medical-record documentation and report them appropriately.
- Communicate with other clinical team members regarding documentation.
- Use coding reference materials, including coding books and the 3M encoder, appropriately and efficiently.
- Follow hospital and department policies and procedures, including requirements for release of information, amendments to medical records, and other legal matters.
- Assist in orienting and training new department staff.
- Complete and maintain required education and training.
- Comply with HIPAA regulations and maintain patient confidentiality.
- Follow lawful safety and health requirements, regulations, and protocols for required protective equipment.
- Promptly report safety issues, job-related injuries or illnesses, and near misses in SafetyZone.
- Follow Hillsboro Health Standards of Behavior.
- Attend required training or meetings under Hillsboro Health’s Corporate Compliance Plan and Code of Conduct, understand compliance responsibilities, and know when to contact the Corporate Compliance Officer about concerns regarding fraud or abuse.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
