Job: Medical Records- Coding Specialist II
Job Description
Job Type: Full time, Hourly
Wage: $22.58-$34.20/hr.
Location: Salida, CO.
Job Description
HRRMC's Medical Records Department has a full time (40 hrs/week) position as a Medical Records Coding ll Specialist. Previous experience in a medical setting is required. The hours for the position will be Monday -Friday 7am to 4 pm. Apply online at hrrmc.com
SUMMARY:
Responsible for reviewing medical record documentation and applying appropriate diagnostic, procedure, and level of service codes for hospital, ancillary, outpatient clinic, and professional fee accounts as assigned for data retrieval, analysis, and claims processing. Ensures ethical and accurate coding in accordance with all regulatory requirements and the AHIMA Standard of Ethical Coding.
ESSENTIAL DUTIES PER AREA OF RESPONSIBILITY
1. Ability to perform all duties of the Coding Specialist I Job Description with a high degree of proficiency and accuracy.
2. Reviews and analyzes medical records as assigned for complete and accurate documentation of all relevant diagnoses and procedures.
3. Accurately assigns codes and abstracts principal diagnoses, complications, comorbid conditions, and procedures for all payor sources on inpatient or outpatient record types; enters data into the facility information system. Ability to code inpatient and/or outpatient accounts proficiently.
4. Provides thorough, timely, and accurate assignments of codes and ensures codes reflect patient severity. Ensures that codes and charges are supported by medical record documentation.
5. Consults with or queries medical providers to clarify missing or inadequate information. Facilitates the timely completion of queries. Completes query trending spreadsheet and reports monthly to management.
6. Collaborates with providers to obtain a greater level of specificity documented in the medical record and to ensure the record reflects the severity of illness and risk and mortality.
7. Verifies abstracted hospital information fields for accuracy and completeness, correcting as appropriate based upon information obtained from the medical record.
8. Conducts initial review of denials by agreeing or appealing coding change. Provides appropriate documentation from required source to assist management when appealing an adverse determination.
9. Enhances efficient revenue cycle operations by providing coding knowledge and expertise to pre-receivable processes with the goal of preventing claim errors and payer rejections/denials. Assists with rejections and denials related to coding issues to both assist with resolution and to recommend front-end processes or edits that will allow the rejection/denial to be avoided.
10. Completes the Not Final Coded Days and Dollars spreadsheet on a daily basis. Reports issues/concerns to the director and/or designee.
11. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding and AHA Coding Clinic guidelines and advice.
12. Maintains 95% or greater accuracy in abstracting and code assignment.
13. Meets or exceeds coding established productivity standards and works as a team to maintain Discharged Not Final Coded (DNFC) days at or below three days.
14. Performs interim billing coding.
15. Monitors coding edits and resolves issues and reports trends to the director and/or designee.
16. Develops and runs reports, analyzes data, and prepares trending matrices.
17. Maintains coding proficiency through self-directed continuing education. Maintains knowledge of current trends, updates, and changes in coding policy and procedure.
18. Participates in the orientation, training, and mentoring of coworkers.
19. Performs other functions and special projects assigned by the director and/or designee.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Requirements
EDUCATION AND OR EXPERIENCE: EDUCATION
Required:
- Graduate from an accredited HIM program or coding certification program; or training/experience equivalent to the two-year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations.
- ICD-10 training
Preferred:
- Associate or bachelor’s degree in a related health care field.
EXPERIENCE
Required:
- Minimum of three years of healthcare experience working in a medical records department, patient financial services department or provider practice.
- Minimum of three years’ experience coding outpatient or inpatient services and successful completion of a coding proficiency examination.
- Experience with electronic health records, encoder, and computer-assisted coding systems.
- Experience in training others.
- Customer service experience.
Preferred:
- Coding auditing experience.
All offers of employment are contingent upon the successful completion of a negative drug screen test*, criminal background check, reference checks, infection prevention procedures (TB test, Flu Shot, immunization records, etc.), physical capacity profile and acknowledgement of policies.
**Disclaimer: The duties and responsibilities described above are not a comprehensive list and additional tasks may be assigned to the employee, time to time; the scope of the job may change as necessitated by business demands. Click “Visit” below for more detail on this specific job.