What are the responsibilities and job description for the CODING SPECIALIST - OUTPATIENT (Medical Group) position at Calvert Health System?
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JOB DESCRIPTION DETAILS
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Reports to:
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HIM Coding Manager
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Job Summary:
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Codes and abstracts outpatient medical records in accordance with established coding conventions and guidelines.
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Education:
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Associate's or Bachelor's degree in Health Information Management (HIM) or Coding, preferred. Position requires formal working knowledge equivalent to a two or four year degree in HIM or Coding.
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Registration/Certification/Licensure:
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AHIMA Certifications (RHIA, RHIT, CCS, CCS-P)
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AAPC Certifications (CPC, CPC-H)
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Experience:
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1 year of medical coding experience in a clinical, hospital, or physician office setting
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Possess a strong grasp of: Ambulatory Payment Classifications (APC's), all Patient Refined Diagnosis Related Groups (APR-DRGs) - Maryland, andPotentially Preventable Complications (PPCs)/Maryland Hospital Acquired Conditions (MHACS) experience, required.
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Familiarity with Meditech and 3M Coding and Reimbursement System, preferred.
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360 Encompass experience, a plus.
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Other Requirements:
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Maintains unit-specific and hospital competencies, mandatory learning, and any clinical certifications required in accordance with the Staff Education and Training policy GA-057 and/or any other department requirements.
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Comprehensive knowledge of Pathophysiology, disease processes, Pharmacology and Medical Terminology.
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Ability to effectively communicate with clinical and non-clinical staff, both verbally and in writing.
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Knowledge of HIM workflow.
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Ability to complete and submit physician queries as appropriate.
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Effectively communicates with clinical and non-clinical staff, both verbally and in writing, by implementing organization-wide communication techniques as a daily practice.
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Demonstrated proficiency of computer skills necessary to effectively complete position requirements.
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Ability to work independently and prioritize tasks producing quality work that is timely.
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FLSA Status:
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Non-Exempt
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Populations Served/Patient Care Responsibilities
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All age populations
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TECHNICAL COMPETENCIES
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Principle Duties and Responsibilities:
- Reviews clinical documentation and diagnostic results to accurately extract data and assign appropriate ICD-10-CM/CPT codes for billing internal and external reporting, research and regulatory compliance.
- Accurately assigns codes utilizing ICD-10-CM and CPT codes for inpatient and outpatient records as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.
- Assigns principal and secondary diagnosis and procedure codes using the computer system and encoder.
- Works with the Clinical Documentation Analyst to assist in the development and improvement in the Clinical Documentation Improvement program (inpatient).
- Contacts physicians when recognizing when further documentation clarification is needed for accurate coding and appropriately queries the physician.
- Abstracts required data elements as instructed.
- Establishes and maintains an outpatient coding accuracy rate of 95% or greater.
- Establishes and maintains an outpatient coding production rate of 90% or greater.
- Ensures HIPAA compliance at all times.
- Abides by the standards of Ethical Coding set forth by the American Health Information Management Association (AHIMA).
- Attends coding specific hospital meetings with the Director of HIM and/or the Coding Manager.
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