Clinical Coding Specialist
Position Summary This position is responsible for final coding of outpatient account types. Clinical Coding Specialist must be able to assign ICD-10-CM and CPT codes to outpatient encounters including emergency department visits, clinic visits, oncology treatment visits, recurring outpatient therapy and infusion center visits, diagnostic exams and testing, and laboratory reference accounts.
Attention to detail is required for accurate capture of data elements, knowledge of coding and regulatory guidelines, and billing rules, commitment to ethical and compliant coding practices.
- Education Associates of Health Information Administration - Required
- Experience 1 Year outpatient coding experience - Preferred (applies to certified applicants) 5-7 Years of comparable experience - Required (applies to non-certified applicants)
- License & Certification Certification by American Health Information Management Association (AHIMA) CCA, RHIT, RHIA, CCS;
or certification by the American Academy of Professional Coders (AAPC) CPC or COC - Preferred
Core Job Functions Accurately reviews medical records and assigns diagnosis and procedure codes utilizing the computerized encoding software system;
resolves all national correct coding and outpatient code edits; and appends appropriate modifiers to CPT and HCPCS codes.
Abstracts required information as needed. Validates admission and discharge data; reviews account for any aberrant charges.
Follows the standards of professionalism set forth by AHIMA and AAPC. Ethically and accurately assigns diagnosis codes in compliance with the ICD-10-CM Official Coding Guidelines, Coding Clinic, and CPT procedure codes in accordance with the CPT guidelines and CPT Assistant guidance.
Reviews record for missing documentation that prevents final coding and places the account on hold. Monitors accounts on hold.
Maintains certification and engages in continuing education activities. Stays up-to-date on regulations including national and local policies.
Shares knowledge with the rest of the team. Able to work independently and maintain quality and productivity standards in a remote, HIPAA compliant home environment to ensure goals are met.
Identifies and escalates any obstacles to fulfilling job responsibilities. Takes initiative to resolve technical issues and maintains strong communication with coding management.
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