Coding Specialist II Remote - (TX, AR, FL, WI residents only)
Date: Jan 14, 2025
Location: Dallas, TX, US
Category: Allied Health and Clinical Support Jobs
Job Type: Any
Schedule Type: Full-Time
Requisition ID: 968595
Must live in TX, AR, FL or WI
Primary Purpose
The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting, and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters. This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes.
Education
- High school diploma required.
- Must have successfully completed an approved coding program.
- OR must be a graduate of a Health Information Management program.
- Must have strong knowledge of Anatomy and Physiology and possess strong application skills.
Experience
- Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties.
- Physician office coding, charging, and billing experience preferred.
Equivalent Education and/or Experience
- May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.
Certification/Registration/Licensure
- Must be certified through the American Health Information Management Association (AHIMA) as one of the following:
- Registered Health Information Management Administrator (RHIA)
- Certified Coding Specialist (CCS)
- Certified Coding Specialist-Physician Based (CCS-P)
- OR Must be certified through the American Association of Procedural Coders (AAPC) as one of the following:
- Certified Professional Coder (CPC)
- Certified Professional Coder-Hospital (CPC-H)
Skills or Special Abilities
- Advanced coding and charge review skills understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations.
- Advanced knowledge of ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage for hospital and professional billing.
- Score a minimum of 80% on a pre-employment coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
- Must have knowledge of medical terminology, the human disease process, anatomy and physiology.
- Demonstrate proficiency in coding and encoder skills.
- Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC).
- Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.
Responsibilities
- Code, abstract and conduct charge quality review on all episodes of care on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS) and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines, and hospital policy.
- Assign appropriate diagnosis and procedures codes utilizing ICD 10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to the Centers for Medicare & Medicaid Services (CMS) requirements for both professional and hospital billing.
- Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
- May verify, edit and/or enter charges based on documentation or payer/billing requirements reporting any discrepancies in a timely manner.
- Updates patient database with classification codes and resolves conflicts or inconsistencies.
- Stays abreast of the latest developments, advancements, and trends in the field of health information management.
- Identifies ways to improve work processes and improve customer satisfaction.
- Facilitate a positive working relationship with physicians, nurses, and medical staff.
- Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the Coding area.
- Maintains CE hours and renew annual coding credentials.
Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.
Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth
Job Segment: Medical Coding, Emergency Medicine, Healthcare Administration, Patient Care, Medicare, Healthcare
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