Title: Coding Documentation Specialist – Site Level II
Shift: Full Time, Days
Job Overview: The Coding Documentation Specialist II will be responsible for interpreting clinical documentation/records from patient records to ensure all diagnoses and procedures are documented and coded accurately. This position will also ensure the highest level of reimbursement practice efficiencies and compliance related to coding procedures and will also provide feedback and support to physicians.
The Coding Documentation Specialist II may perform the following duties:
- Responsible for translating healthcare providers’ diagnostic and procedural documentation into coded form, applying regulatory and organizational guidelines.
- Review patient reports and extract data necessary to apply appropriate ICD and CPT codes for billing, internal and external reporting, research and regulatory compliance.
- Utilize technical coding principals and reimbursement rule expertise to assign appropriate ICD diagnosis and CPT procedures as appropriate, with understanding of E/M coding elements.
- Facilitates healthcare provider education in areas of CMS regulations, coding, billing, documentation and administrative guidelines.
- Utilize understanding health record content to extract pertinent information required to support or provide specificity for accurate coding.
- Code at a productivity and quality rate consistent with organizational standards.
- Identify and research encounters with potential to impact The Christ Hospital Health Network (TCHHN) inpatient related bills to ensure compatibility and compliance.
- Analyze denial and rejection reports and appeals when necessary to ensure compliance with payor and/or regulatory requirements.
- Provide feedback and impact to the Healthcare physician/provider and office manager regarding denial and rejection trends.
- Monitor documentation and coding practices to identify and follow up on potential coding related compliance issues and/or missed revenue potential.
- Maintain current knowledge base in all aspects of CPT, HCPCS and ICD-9-CM and ICD -10-CM coding.
- Keep abreast of all current billing and coding rules and regulations affecting government and non-government payers, and disseminates information to appropriate individuals as needed.
- Reviews and researches coding/billing issues, including but not limited to, rejection reports and claim denials.
- Perform regular analysis of the impact of coding and clinical documentation on reimbursement and identify trends and opportunities for improvements.
- Adhere to compliance regulations, the Christ Hospital Code of Conduct, and the Christ Hospital Core Values and AHIMA code of Ethics while performing all duties detailed.
- All other duties as assigned.
Education: Skills assessment required to determine competency level of coding skills. Associate degree in HIM with RHIT or Certified Coder Specialist-Physician (CCS-P) or Certified Professional Coder (CPC) required.
Experience: Combination of approved education and/or 3 years related experience. Radiology/Oncology coding experience preferred.
Required Skills and Knowledge:
- Demonstrated knowledge of ICD-9, ICD-10 and CPT coding guidelines, medical terminology, anatomy and physiology.
- Ability to accurately code diagnostic and surgical procedures with a depth of knowledge in Evaluation and Management (E/M) coding.
- Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation.
- Demonstrated effective verbal and written communication skills.
- Research skills including knowledge of automated analysis tools and on-line research tools to resolve coding and healthcare issues.
- Demonstrated ability to effectively work within a team environment, using excellent written, verbal, and presentation skills to share audit findings, risk areas, and compliance issues with coders, office managers, physicians, etc.
- Maintains confidentiality and protects sensitive data at all times.
There are many ways to define excellence. For us at The Christ Hospital, it’s all about our patients...And making healthcare what they want it to be. Accessible. Personal. Affordable.
Our commitment to exceptional outcomes, affordable care and the finest patient experiences is recognized yearly with numerous awards from leading healthcare organizations and publications. At the top of our list of honors are the 17 consecutive years that we’ve been named to U.S. News & World Report’s list of Best Hospitals and being named the Most Preferred Hospital by the Greater Cincinnati community for 21 consecutive years (National Research Corporation).
What does this mean for you?
GROWTH- opportunities to learn, develop, and impact.
VALUE - a robust employee package that provides you the ability to maintain a healthy work-life balance, competitive compensation, flexible and meaningful benefits, development opportunities so you can be your best self, and a culture of compassion.
PRIDE- from all that we have accomplished in our past, and all that we’re positioned for in the future.
CHALLENGE- we are in one of the most competitive markets in the nation, yet continue to rise to the top through our incredible employees and transformational results. We seek individuals motivated by what it takes to be a part of a winning team.
Named #24 on Forbes 500 America’s Best Employers for 2017, we are transforming care…inspired by you.