About this role
Role Overview
- The Coding Specialist III will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement.
- Coding Specialist III validate MSDRG and/or APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record.
- Coding Specialist III performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements.
- Coding Specialist III may interact with client staff and providers.
- Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but is not limited to: Acute Inpatient, Observation/Rehabilitation/Psychiatric/SNF; Ambulance and Ambulatory Surgery; Wound Care, Emergency Department, Ancillary (Diagnostic) / Recurring; Interventional Radiology; Hospital Clinic.
- Review and analyze clinical records to ensure that MSDRG/APC assignments accurately reflect the diagnoses/procedures documented in the clinical record.
- Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
- Complete assigned work functions utilizing appropriate resources.
- May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
- Maintain strict patient and provider confidentiality in compliance with HIPPA.
- Performs other related duties as assigned or requested.
Requirements
- Candidates must successfully pass pre-employment skills assessment.
- Required: An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
- Three (3) years of recent and relevant hands-on coding experience with all record types: – Acute Inpatient, Observation/Rehabilitation/Psychiatric/SNF; Ambulance and Ambulatory Surgery; Wound Care, Emergency Department, Ancillary (Diagnostic) / Recurring; Interventional Radiology; Hospital Clinic; Physician Pro Fee; Technical Fee; Evaluation and Management.
- Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets.
- Ability to consistently code at 95% threshold for both accuracy and quality while maintaining client-specific and/or Precyse production and/or quality standards.
- Proficient computer knowledge including basic MS Office knowledge. Basic MS Office knowledge includes data entry, sort, filter, copy, paste and password protect functions in Excel and/or Word programs. Basic MS Outlook knowledge is opening and responding to emails and accepting and scheduling meetings using the Outlook calendar.
- Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers.
- Preferred: Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience.
- Recent and relevant experience in an active production coding environment strongly preferred.
- Experience with multiple Electronic Medical Record software applications including but not limited to EPIC, Cerner and Meditech.
- Experience with multiple Encoder software applications including but not limited to 3M and TruCode.
Benefits
- Support Savista's Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient and/or client information.
- Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
- Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
- Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.