Role Description
This Sr Hospital Coding Specialist will facilitate improvement in medical record documentation for purposes of coding, billing and compliance.
Responsibilities
Essential Functions:
• Communicates cooperatively and constructively with physicians, physicians’ office personnel, guests, patients and members of the healthcare team.
• Demonstrates strong verbal and written communication skills.
• Works independently to coordinate information and workflow of corporate functional area.
• Interacts with coding and other teams to ensure completion of corporate and departmental goals.
• Accurately and optimally reviews and codes diagnoses and procedures from electronic medical records using ICD-9-CM, ICD-10-CM/PCS, and/or CPT-4 coding classification systems and the encoder, CAC, and other apps as instructed.
• Properly sequences diagnoses and procedures according to UHDDS definitions for 837i billing.
• Participates in the biannual quality audit and maintains 95% or better accuracy.
• Accurately abstracts information into the hospital information system(s).
• Demonstrates an understanding of all coding updates and changes in coding guidelines and provides expertise for team.
• Assists the coding management team in medical record reviews for third party audits, denied claims, medical necessity, pre-bill reviews, focused audits, etc.
• Works with Patient Accounting and ancillary areas to assure appropriate and timely billing on all accounts.
• Collects and provides data for statistical reports to coding management team as required.
• Completes concurrent reviews for purposes of documentation enhancement, interim billing, etc.
• Demonstrates exemplary customer service and critical thinking skills to include problem resolution and process improvement skills.
• Tracks/trends opportunities for physician education.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.
Other Related Functions:
• Maintains established work production standards.
• Works as a team member in facilitating efficient and effective problem solving to meet goals.
• Establishes and maintains an environment of positive motivation through individual and group interaction.
• Assumes responsibility for professional growth and development.
• Attends department and other meetings as required.
Qualifications
• Associate degree in Health Information Management; or completion of American Health Information Management Association's Independent Study program (AHIMA).
• Computer literacy required.
• Score of 85% or better on Orlando Health coding skills test.
Requirements
• Must maintain one of the following:
• Registered Health Information Administrator (RHIA)
• Registered Health Information Technician (RHIT)
• Certified Coding Specialist (CCS)
• Coding Associate (CCA) by the American Information Management Association (AHIMA) – renewed every 2 years.
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) – renewed every 2 years.
• Two (2) years previous hospital coding experience required.
• Thorough knowledge of both ICD-9-CM, ICD-10-CM/PCS, and CPT-4 coding classification systems required.