Hospital Coding Specialist II

West Tennessee Healthcare • Jackson, MS

6d

About The Position

The Hospital Coding Specialist II is responsible for coding and optimizing electronic medical records. The role works an assigned 8-hour shift, 5 days a week, and is subject to call back and overtime as required by the hospital. The specialist reviews records, assigns and sequences diagnosis and procedure codes, ensures coding and billing accuracy, supports compliance and medical necessity, and addresses documentation, audit, denial, and reimbursement issues. The position also requires maintaining coding certification, completing assigned training, attending required onsite meetings, and meeting productivity and accuracy standards.

Requirements

• Current RHIT, RHIA, or CCS certification from AHIMA, or AHIMA CCA certification with a minimum of 3–5 years of hospital coding experience.
• Knowledge of Health Information Management practices, coding, and coding guidelines.
• Skill and proficiency in diagnosis and procedure coding and other Health Information Management principles, concepts, and techniques.
• Meet all experience requirements for Coding Specialist I.
• Ability to code a minimum of 45 outpatient surgery and observation records per day.
• Strong knowledge of ICD-10 Official Guidelines for Coding and Reporting from CMS and NCHS, AMA CPT Coding Guidelines, and AHIMA Standards of Ethical Coding.

Responsibilities

• Review electronic medical records and identify treated diagnoses and significant procedures performed.
• Use coding software to assign ICD-10-CM diagnosis codes and CPT procedure codes and modifiers, when indicated, to ensure coding and APC accuracy.
• Sequence diagnosis and procedure codes according to primary diagnosis, co-morbid conditions, complications, primary procedure, and other procedures.
• Use online coding references, CMS Local Coverage Determinations, and other payor guidelines to support appropriate code assignment for compliance, billing, and medical necessity.
• Ensure diagnosis and CPT procedure codes and modifiers, procedure dates, and surgeons are accurately transferred from coding software to the coding and billing application.
• Identify and communicate documentation opportunities related to appropriate code assignment, and complete physician queries when clarification is needed.
• Use the abstracting application to enter or update Consulting Physicians, Discharge Dispositions, and Attending Physician.
• Enter surgical procedure charges into the billing system for invasive surgical procedures performed in the Radiology Department and Pain Clinic.
• Review and respond to internal and external coding audits in a timely manner.
• Review and resolve coding- and reimbursement-related denials and edits to ensure timely claim submission.
• Stay informed about changes in coding and billing and maintain compliance with federal, state, and hospital policies.
• Complete assigned online training and education activities on time and attend required onsite meetings.
• Respond professionally and promptly to emails and requests from the Supervisor, Manager, and other hospital employees.
• Meet required productivity and accuracy standards.
• Maintain coding certification.
• Perform related responsibilities as required or directed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed