Coding Review Specialist - HIM- Days - FT

The Coding Review Specialist is responsible for daily auditing, monitoring, and follow-up to ensure coding compliance. The Specialist assigns appropriate codes to patient diagnosis and procedures and provides support to the coding staff. The Specialist monitors and documents coding trends.

Responsibilities

• Responsible for performing coding compliance review
  • Audits clinical documentation and coded data to validate documentation services rendered for reimbursement and reporting purposes
  • Identifies discrepancies and billing issues; recommends a plan of action to correct discrepancies and prevent future coding errors
  • Assures that accounts are grouped to the appropriate classification utilizing ICD diagnosis and procedure codes
  • Reviews accounts assigned to work queue to determine if a clinical association exists for possible combined billing referencing various rules and regulations
  • Monitors and reports the outstanding account reviews to facilitate account billing
  • Ensures compliance with established guidelines and regulatory requirements
• Serves as a resource and subject matter expert to coding staff and interdisciplinary teams
  • Assists in coordinating external third party annual coding audits
  • Works with medical and business office staff to resolve coding issues and associated problems
  • Serves as a liaison to Revenue Cycle to provide effective communication of concerns between Patient Financial Services and Coding Management
• Assigns ICD and CPT codes to patient diagnoses and procedures
  • Ensures assignment of codes are consistent with coding guidelines and regulations
  • Assigns Ambulatory Payment Classification (APC) promptly and accurately
  • Groups patient diagnostic information according to regulations utilizing ICD diagnosis and procedure codes
  • Enters coded and abstracted data into the hospital information system

Qualifications

Education:

• High School or GED

Experience:

• 4 years as a medical coder for an acute care facility

Skills:

• Analyzing and organizing technical data
• Multitasking, time-management, and organization
• Verbal and written communication