MEDICAL CODING SPECIALIST I

VALOR HEALTH•Emmett, ID

1d•Onsite

About The Position

Analyzes physician/provider documentation within the patient record to determine the principal and secondary diagnoses and procedures. Utilizes encoder software applications in the assignment of ICD10-CM codes and CPT-4/HCPCS procedure codes. Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA), and American Health Information Management Association (AHIMA).

Responsibilities

Navigates the patient health record and codes outpatient records utilizing encoder software, in the assignment of ICD-10, CPT-4 and HCPCS codes. Assign codes in accordance with AHA Coding Clinic for ICD-10, AMA CPT Assistant, AHIMA’s Standards of Ethical Coding, as well as Valor Health’s established coding standards and guidelines.
Abstracts additional health record information for use in data collection, retrieval of health care statistics, maintenance of required disease and operative indexes, quality assurance monitoring activities, and data base maintenance for use by hospital administration, committees, medical staff, and accrediting, licensing, and regulatory agencies.
Works closely with the Revenue Integrity Specialist for appropriate charge assignment
Validates charges, when necessary, by comparing charges with health record documentation.
Responds to and resolves automated edits in 3M.
Communicates effectively with clinical staff, physicians, and office staff regarding documentation.
Recognize opportunities for documentation improvement and formulate clinically credible queries.
Maintains the coding of hospital discharged records within 96-hours of discharge
Meets or exceeds productivity and quality expectations. This is monitored and reported on a monthly basis.
Abides by confidentiality requirements as they relate to the release of individual or aggregate patient information.
Maintains up-to-date knowledge of changes in coding guidelines and regulations. Participates in educational opportunities to enhance knowledge in coding and reimbursement systems.
Maintains and enhances professional growth and career development by participation in activities directly related to responsibilities, such as reading journals and coding articles, participating in education programs, webinars, and continuing membership in professional affiliations.
Other duties and responsibilities as assigned