Coding Quality Assurance Specialist III

Texas Children's Hospital; Houston (TX); On-site; USD 50,000 - 90,000; Full time

Job summary

An established industry player is seeking a Coding Quality Assurance Specialist III to join their dynamic team. In this pivotal role, you will ensure the accuracy of coding for various medical records, including ambulatory and emergency center records. Your expertise in ICD-10-CM, CPT coding, and experience with electronic medical records will be crucial in maintaining high standards of billing and compliance. This position offers the opportunity to contribute to a leading children's hospital renowned for its commitment to patient care and innovation. Join a team that values your skills and dedication to improving healthcare for children and families.

Qualifications

• 4 years coding experience required, with encoder and EMR experience preferred.
• Certifications from AAPC and AHIMA are mandatory.

Responsibilities

• Assign and audit ICD-10-CM and CPT codes for various medical records.
• Review physician documentation for accurate coding and provide feedback.

Skills

ICD-10-CM coding

CPT coding

encoder usage

electronic medical record experience

communication skills

Education

High School Diploma or equivalent

Tools

Epic

MIQS

Cardio IMS

Job description

Position: Coding Quality Assurance Specialist III

Talent Area: Administrative Support

Full/Part Time: Full time

Location: Houston, TX, US

Shift: Days shift

Job ID: 416572

We’re looking for a Coding Quality Assurance Specialist III, someone who’s ready to grow with our company. In this position you will assign and audit the accuracy of the ICD-10-CM and PCS codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. Ascertains the accuracy of the physicians' E/M and procedure coding to their documentation and completes the auditing reporting tool and provides this feedback to the education team and/or provider. Incumbent may perform only certain of the following responsibilities depending on their work assignment.

Job Duties & Responsibilities

1. Assigns ICD-10-CM, ICD-10-PCS, and/or CPT codes.
2. Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.
3. Communicates with and provides feedback to the education team and/or providers.
4. Reviews patient charges to determine necessary coding to complete the account.
5. Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.
6. Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
7. Sequences diagnosis and procedures to generate appropriate billing.
8. Queries physicians to obtain diagnosis if not clearly provided in records.
9. Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, and coding reference materials).
10. Assists other coders in resolving coding problems.
11. Provides ICD-10 and CPT, for physician research projects, and for quality reporting purposes.
12. Completes abstracts for records as appropriate.
13. Assists in correction of problem accounts.
14. Reviews charts for completeness.
15. Participates in education and maintains certification.
16. Assists in auditing records.
17. Maintains concurrent coding for inpatient records.

Skills & Requirements

• Required High School Diploma or equivalent
• Required Licenses/Certifications:
  • oCCA - Certified Coding Associate by the American Academy of Professional Coders (AAPC)
  • oCCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)
  • oCCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)
  • oCIPC - Certified Inpatient Coder by the American Academy of Professional Coders (AAPC)
  • oCOC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)
  • oCPC - Cert-Cert Professional Coder by the by the American Academy of Professional Coders (AAPC)
  • oCRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC)
  • oRHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)
  • oRHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)
• Required 4 years coding experience with preferred experience using an encoder and experience using an electronic medical record

Inpatient coding experience highly desired

About Texas Children’s

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.

Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children ’ s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children ’ s Hospital West Campus, a community hospital in suburban West Houston; Texas Children ’ s Hospital The Woodlands, the first hospital devoted to children ’ s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children ’ s Health Plan, the nation ’ s first HMO focused on children; Texas Children ’ s Pediatrics, the largest pediatric primary care network in the country; Texas Children ’ s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children ’ s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.