POSITION SUMMARY

The purpose of the HIM Coding Specialist position is to assign appropriate ICD-10-CM, CPT, and HCPCS code(s) to patient health information, as documented in the medical record for data retrieval, data analysis, and proper reimbursement. Additional responsibilities include: assistance with ICD-10-CM ongoing staff education on yearly coding updates, conducts focused coding education for staff, performs audits, prepares reports, and participates in other HIM department functions as assigned.

QUALIFICATIONS

Education: Associate Degree in Health Information Management with RHIT, CCS, CCS-P, or CPC coding credential required. A specific coding credential (CCS, CCS-P, CPC or HCS-H) is required to obtain within 6 months of employment, if not in possession of one of the above credentials. If not degreed, must have in-depth knowledge of anatomy and physiology and pathophysiology, as it relates to coding. Knowledge of basic pharmacology.

Experience: A minimum of three (3) years coding in a healthcare setting required. Must have experience in the assignment of ICD-10-CM, CPT, and HCPCS codes to medical record documentation. Expert knowledge of coding principles and guidelines related to regulatory compliance.

Additional Requirements: Must have valid driver’s license, automobile insurance, personal vehicle, ability to travel between locations and work flexible hours.

PRIMARY RESPONSIBILITIES

• Upon admission, reviews clinical documentation and assigns the primary and secondary ICD-10-CM code(s) and identifies co-morbidities.
• Reviews and performs ongoing monitoring of ICD-10-CM code assignment for coding accuracy through regular and focus audits.
• Educates clinical staff on the choice of appropriate ICD-10-CM codes based on their clinical documentation, in order to meet regulatory guidelines and support of maximum reimbursement. Discusses alternative codes and possible additional documentation as wells as educates staff, as needed.
• Serves as a resource for directors, managers, physicians, clinicians, and administrative staff to obtain coding information or coding clarification, as needed.
• Coordinates with the Compliance department staff regarding issues identified in coding audits.
• Coordinates with the HIM Director and Compliance Officer/Risk Manager as needed.
• Reviews and assigns CPT codes to physician visits for all service lines that have been identified on billing sheets, Electronic Health Record (EHR) documentation, or other electronic system(s).
• Queries physicians when code assignments are not straightforward or documentation is inadequate, ambiguous, missing, or unclear for coding purposes.
• Reconciles hospice physician visits with EHR reports to ensure all visits that have been captured, verify correctly entered and submits weekly to the Patient Accounts Department. Collaborates on any discrepancies for corrections. Keeps the HIM Director and the Patient Accounts Manager informed of any issues and when completed.
• Cross-trained in other duties within the HIM department, including the capability to back up an Office Coordinator or Unit Secretary as needed.
• Maintains strict confidentiality at all times.
• Utilizes and models excellent customer service skills at all times; seeks opportunities to assist patients, families and co-workers; demonstrates teamwork and cooperation.
• Accepts direction and follows instructions from supervisor; seeks additional information as needed; works with minimal supervision.
• Adheres to all organizational and departmental policies and procedures.
• Continually meets organizational standards for attendance and punctuality; notifies supervisor in a timely manner when employee will be absent or late for work.
• Attends all required meetings and in-services; seeks opportunities for additional professional development activities as appropriate.
• Completes special projects and other duties as assigned by HIM Director.

COMPETENCIES, KNOWLEDGE, SKILLS, AND ABILITIES

THIS SECTION DESCRIBES WHAT KNOWLEDGE, SKILLS AND ABILITIES AN EMPLOYEE IN THIS POSITION SHOULD CURRENTLY POSSESS. THIS LIST MAY NOT BE COMPLETE FOR ALL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED FOR THIS POSITION.

• Competent in the use of electronic medical records systems Microsoft Office, Forcura, and online research for coding issues.
• Skill in organizing and prioritizing workloads to meet deadlines.
• Ability to communicate effectively both orally and in writing with co-workers and physicians.
• Ability to follow basic safety policies and procedures.
• Ability to use good judgment and to maintain confidentiality of information.
• Ability to work as a team player.
• Ability to demonstrate tact, resourcefulness, patience and dedication.
• Ability to accept direction and adhere to policies and procedures.
• Ability to work in a fast-paced environment and manage multiple priorities.

Performs the above listed functions while regularly working with confidential and/or proprietary Arkansas Hospice and patient information, including but not limited to patient medical records, current or former employee information, Arkansas Hospice records, and other information that the employee regularly uses to perform job functions.

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