Coding Quality Assurance Specialist III

Description

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 DRG codes to Inpatient 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 Responsibility depending on their work assignment.

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Job Duties & Responsibilities

• Assigns ICD-10-CM, ICD-10-PCS, DRG, E/M and/or CPT codes.

• Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.

• Communicates with and provides feedback to the education team and/or providers.

• Reviews patient charges to determine necessary coding to complete the account.

• Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.

• Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.

• Sequences diagnosis and procedures to generate appropriate billing.

• Queries physicians to obtain diagnosis if not clearly provided in records.

• Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, and coding reference materials).

• Assists other coders in resolving coding problems.

• Provides ICD-10 and CPT, for physician research projects, and for quality reporting purposes.

• Completes abstracts for records as appropriate.

• Assists in correction of problem accounts.

• Reviews charts for completeness.

• Participates in education and maintains certification.

• Assists in auditing records.

• Maintains concurrent coding for inpatient records.

Skills & Requirements

• Required High School Diploma or equivalent

• Requires one of the following Licenses/Certifications

o CCA - Certified Coding Associate by the American Academy of Professional Coders (AAPC)

o CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)

o CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)

o CIPC - Certified Inpatient Coder by the American Academy of Professional Coders (AAPC)

o COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)

o CPC - Cert-Cert Professional Coder by the by the American Academy of Professional Coders (AAPC)

o CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC)

o RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)

o RHIT - 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