Hospital Coding Specialist III

West Tennessee Healthcare; White Deer (TX); On-site; USD 60,000 - 78,000; Full time

Job summary

West Tennessee Healthcare in Jackson, TN is seeking a Hospital Coding Specialist III to perform medical record coding and optimization on an 8-hour day shift.

The role requires expertise in ICD-10-CM/PCS and CPT coding, adherence to CMS/NCHS/AMA guidelines, and DRG optimization to support accurate billing and compliance. Strong documentation improvement and communication with CDI will be essential.

Qualifications

• Knowledge of ICD-10-CM/PCS and CPT coding guidelines.
• AHIMA RHIA/RHIT/CCS certification or AHIMA-accredited program.
• Ability to code 15–20 inpatient records per day.

Responsibilities

• Code ICD-10-CM/PCS and CPT codes for inpatient records.
• Ensure DRG optimization for accurate billing.
• Adhere to CMS/NCHS/AMA guidelines and coding standards.
• Identify documentation opportunities and complete physician queries.
• Use coding software to transfer codes to billing applications.
• Respond to coding audits and denials in a timely manner.

Skills

ICD-10 coding

CPT coding

DRG optimization

Documentation improvement

AHIMA guidelines

Education

RHIA/RHIT/CCS certification

Tools

Coding software

CDI applications

Abstracting software

Job description

Category:

Admin Support

City:

Jackson

State:

Tennessee

Shift:

8 - Day (United States of America)

Job Description Summary:

Hospital Coding Specialist III is responsible for the coding and optimization of electronic medical records. Incumbent is responsible for assigned 8-hour shift, 5 days a week.Employee is subject to call back and overtime as required by the hospital.

Essential Job Functions:

• Strongly knowledgeable of the ICD-10 Official Guidelines for Coding and Reporting provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) and the American Medical Association (AMA) CPT Coding Guidelines. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
• Reviews electronic medical records and identifies all treated diagnoses and significant procedures performed.
• Uses coding software to assign ICD-10-CM diagnosis and ICD-10-PCS procedure codes, Present on Admission Indicators, and CPT codes and modifiers when indicated, to ensure coding accuracy, DRG optimization and APC accuracy.
• Sequences diagnosis codes according to the definition of principal diagnosis and other co-morbid conditions and complications. Sequences procedure codes according to the definition of principal procedure and other procedures.
• Utilizes online coding references, CMS Local Coverage Determinations (LCDs), and other payor guidelines to ensure appropriate code assignment for Compliance, Billing, and Medical Necessity.
• Ensures all diagnosis and procedure codes, present on admission indicators, modifiers, procedure dates, and surgeons are accurately transferred from the coding software to the coding and billing application.
• Identifies and communicates documentation opportunities relative to appropriate coding assignment. Completes physician queries as indicated for clarification of documentation.
• Makes data entry in the coding software for Clinical Documentation Improvement (CDI) reviews to effectively communicate with CDI Specialists regarding differences in DRG assignment, Mortality reviews and Quality reviews including Patient Safety Indicators (PSI’s) and Hospital Acquired Conditions (HAC’s).
• Utilizes abstracting application to enter and /or update Consulting Physicians, Discharge Dispositions, and Attending Physician.
• Reviews and responds to internal and external coding audits in a timely manner.
• Reviews and resolves coding and reimbursement related denials and edits to ensure timely submission of claims.
• Remains informed of continual changes in coding and billing and maintains compliance with federal, state and hospital policies.
• Completes all assigned online training and education activities timely and attends all required onsite meetings.
• Responds to e-mails and requests from Supervisor, Manager and other hospital employees in a professional and timely manner.
• Consistently meets required productivity and accuracy standards.
• Responsible for maintaining coding certification.
• Performs related responsibilities as required or directed.

Job Specifications:

EDUCATION:

• Skill and proficiency in diagnosis and procedure coding, and other principles, concepts and techniques of Health Information Management. Such proficiency is acquired through a RHIA, RHIT, or CCS certification or a Health Information program accredited by AHIMA.

LICENSURE, REGISTRATION, CERTIFICATION:

• Registration and/or certification as RHIA, RHIT, or CCS by AHIMA

EXPERIENCE:

• Knowledge of Health Information Management practices, coding and coding guidelines, as acquired through a RHIA, RHIT, or CCS credential. Meets all experience requirements for Coding Specialist I and II and ability to code a minimum of 15-20 hospital inpatient records per day.

NONDISCRIMINATION NOTICE STATEMENT

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.