Job Summary

Under limited supervision, reviews medical records and performs coding on all diagnoses and procedures (both medical and surgical) according to applicable coding guidelines. Assigns and verifies the correct diagnostic related grouping (DRG/MS-DRG) for all inpatient-designated account types, and performs outpatient coding as required. Applies the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient's treatment. Maintains the confidentiality of patient records and procedures.

Minimum Qualifications

School Education:
High School Diploma (or ) GED

Licenses & Certifications:
Certified Coding Specialist (CCS) credential required
Reg Health Information Admin; RHIA/RHIT credential preferred

Work Experience:
Seven (7) Years Work Experience of total coding experience and training with Inpatient and outpatient coding accounts in Trauma Level 1 teaching facility. Coding accounts for Inpatient, Observation, Day Surgery, Specialty Clinics, Emergency Department, Ancillary

Communication Skills: Writing/Correspondence, Writing/Reports

Job Attributes

Knowledge/Skills/Abilities: Analytical, Medical Terminology, Other; Anatomy and Physiology, Inpatient and Outpatient Coding Claim Edit Processing

Work Schedule: Flexible, Holidays, Eligible for Telecommute

Other Requirements:
-Knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology.
-Knowledge of classification systems, ICD-10-CM, and ICD-10-PCS nomenclature, CPT-4 and HCPCS nomenclature, coding rules, guidelines, and proper sequencing.
-Knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS), and the ICD-10-CM, ICD-10-CM, and ICD-10-PCS, CPT-4 Official Coding Guidelines for assignment of diagnostic and procedure codes Knowledge of JCAHO, Privacy Act of 1974, and HIPAA standards affecting medical records and their impact on reimbursement.
-Knowledge of ethical coding principles and revenue cycle activities,
Skilled in interpreting and applying ethical coding standards, understanding federal and state laws and regulations, and following professional practice standards for health care organization coding.