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Role Description

Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements.

Qualifications

• Must be a graduate of a Health Information Management program or must have successfully completed an approved Coding educational program.
• Must have six (6) years of proven coding experience in an acute care setting.
• May have an equivalent combination of education and experience in lieu of specified requirements.
• Must possess one of the following certifications:
  • Registered Health Information Administrator (RHIA)
  • Registered Health Information Technician (RHIT)
  • Certified Coding Specialist (CCS)
  • Certified Professional Coder (CPC)
  • Certified Coding Specialist - Physician (CCS-P)
  • Certified Inpatient Coder (CIC)
  • Certified Outpatient Coder (COC)
  • Certified Professional Medical Auditor (CPMA)
• Must score a minimum of 85% on a pre-employment coding test.

Requirements

• Must be able to demonstrate time management, organizational, oral and written communication skills.
• Must be proficient and demonstrate advanced knowledge in ICD-9-CM and CPT/HCPCS coding and abstracting.
• Must have advanced clinical knowledge of medical terminology, disease process, and pharmacology.
• Must demonstrate knowledge of reimbursement (Medicare and Medicaid) principles and methodologies (MS-DRG and APC).
• Must have a working knowledge of the compliance guidelines related to coding and billing.
• Must have strong skills in diplomacy, professionalism, and trustworthiness.
• Must demonstrate excellent computer skills, including word processing, spreadsheet, and database management software proficiency.

Responsibilities

• Conducts quality reviews on all coders using the "official coding guidelines" as published in AHA Coding Clinic and AMA CPT Assistant, and hospital policy, including specific payer guidelines.
• Analyzes medical record documentation to assure compliance with official coding guidelines.
• Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the coding area.
• Stays abreast of the latest developments, advancements, and trends in medical records coding.
• Assists in ensuring that abstracted coded data and other elements are correct and appropriate.
• Maintains a positive working relationship with physicians, nurses, medical staff, and hospital employees.
• Identifies ways to improve work processes and customer satisfaction.
• This position is 100% Virtual. Virtual employees must comply with all Parkland policies and procedures governing the use of Parkland information resources.

Job Accountabilities

• Identifies ways to improve work processes and customer satisfaction.
• Stays abreast of the latest developments, advancements, and trends in the field.
• Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the area.