Coding Specialist ll - Medical Records

This position has the possibility of working remote.

All offers of employment are contingent upon the successful completion of a negative drug screen test*, criminal background check, reference checks, infection prevention procedures (TB test, Flu Shot, immunization records, etc.), physical capacity profile and acknowledgement of policies.

ESSENTIAL DUTIES PER AREA OF RESPONSIBILITY

1. Ability to perform all duties of the Coding Specialist I Job Description with a high degree
of proficiency and accuracy.
2. Reviews and analyzes medical records as assigned for complete and accurate
documentation of all relevant diagnoses and procedures.
3. Accurately assigns codes and abstracts principal diagnoses, complications, comorbid
conditions, and procedures for all payor sources on inpatient or outpatient record types;
enters data into the facility information system. Ability to code inpatient and/or
outpatient accounts proficiently.
4. Provides thorough, timely, and accurate assignments of codes and ensures codes
reflect patient severity. Ensures that codes and charges are supported by medical
record documentation.
5. Consults with or queries medical providers to clarify missing or inadequate
information. Facilitates the timely completion of queries. Completes query trending
spreadsheet and reports monthly to management.
6. Collaborates with providers to obtain a greater level of specificity documented in the
medical record and to ensure the record reflects the severity of illness and risk and
mortality.
7. Verifies abstracted hospital information fields for accuracy and completeness, correcting
as appropriate based upon information obtained from the medical record.
8. Conducts initial review of denials by agreeing or appealing coding change. Provides
appropriate documentation from required source to assist management when appealing an
adverse determination.
9. Enhances efficient revenue cycle operations by providing coding knowledge and
expertise to pre-receivable processes with the goal of preventing claim errors and payer
rejections/denials. Assists with rejections and denials related to coding issues to both
assist with resolution and to recommend front-end processes or edits that will allow the
rejection/denial to be avoided.
10. Completes the Not Final Coded Days and Dollars spreadsheet on a daily basis. Reports issues/concerns to the director and/or designee.
11. Ensures ethical and accurate coding in accordance with all regulatory requirements and
AHIMA Standards of Ethical Coding and AHA Coding Clinic guidelines and advice.
12. Maintains 95% or greater accuracy in abstracting and code assignment.
13. Meets or exceeds coding established productivity standards and works as a team to
maintain Discharged Not Final Coded (DNFC) days at or below three days.
14. Performs interim billing coding.
15. Monitors coding edits and resolves issues and reports trends to the director and/or
designee.
16. Develops and runs reports, analyzes data, and prepares trending matrices.
17. Maintains coding proficiency through self-directed continuing education. Maintains
knowledge of current trends, updates, and changes in coding policy and procedure.
18. Participates in the orientation, training, and mentoring of coworkers.
19. Performs other functions and special projects assigned by the director and/or designee.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty
satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.