Coding Specialist Certified

SUMMARY

This position is responsible for evaluating medical records and documentation, providing clinical abstracts and assigning appropriate clinical diagnosis and procedure codes in accordance with nationally recognized guidelines. Works collaboratively and supports efforts of other team members. Supports quality improvement initiatives through team participation, data collection, process change implementations, and other activities. Maintains confidentiality and protects sensitive data at all times, including patient information, proprietary information and personnel information. Adheres to organizational and department specific safety standards and guidelines.

ESSENTIAL FUNCTIONS

Analyzes medical information from medical records and accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirement

Provides thorough, timely and accurate assignments of ICD and / or CPT4 codes

Assists in promoting accurate diagnostic information and complete documentation by physicians, nurses and other professionals as required

Consults with medical providers and clinical staff to clarify missing or inadequate records and refers inconsistent patient treatment information / documentation to supervisor or individual department for clarification / additional information for accurate code assignment

Provides Clinic with ICD, CPT and / or HCPC changes quarterly or as needed

Performs other duties as required and assigned

KNOWLEDGE, SKILLS AND ABILITIES

Knowledge of anatomy, physiology and medical terminology

Ability to code records utilizing established coding guidelines and resources

Ability to review all PTFs to ensure all codes are current

Ability to understand and meet coding deadlines to ensure timely submission of bills

Ability to input abstract data and codes into computer to gather administrative and clinical data for distribution to outside regulatory agencies, third -party payers, administrative staff and physicians

Ability to audit physician coding for errors and discrepancies

Ability to maintain confidentiality of patient, personnel, and corporate data

Proficiency in Microsoft Office Suite and relevant software skills

To include position specific : e.g. HRIS, donor database, EHR, practice management systems and tools, enterprise resource planning (ERP) such as Abila, QuickBooks, etc. scheduling software, volunteer management systems, etc.

Ability to effectively manage time with a proven ability to meet deadlines; organization and attention to detail

Ability to operate personal computer, calculator, fax machine, copier, and other office equipment

Qualifications

MINIMUM QUALIFICATIONS

Education :

High school diploma or general education degree (GED), or Associate’s degree or equivalent from two-year College or technical school required

Experience :

Minimum one year related experience required

Licenses and Certificates :

CPC or CCS required

AGE OF PATIENTS ATTENDED BY EMPLOYEE IN THIS POSITION

Check all that apply :

X N / A ___ Neonatal (newborn) ___ Pediatric (birth-13) ___ Young Adult (14-21) ___ Adult (21-65)

FINGERPRINT CLEARANCE

Employees are required to maintain a current Arizona Department of Public Safety Level 1 Fingerprint Clearance Card. Evidence of a current and valid fingerprint clearance card must be received to begin and maintain employment.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands and work environment described here are representative of that which an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle or feel and talk and hear. The employee is occasionally required to stand and walk. Specific vision abilities required by this job include close vision, distance vision, color vision and ability to adjust focus. While performing the duties of this job, the employee may potentially be exposed to infectious organisms during routine and emergency situations. The noise level in the work environment is usually moderate.

BLOODBORNE PATHOGEN CATEGORY : 3

Category 1 : Performs tasks that involve exposure to blood, body fluids or tissue. Use of appropriate protective measures should be required.

Category 2 : Performs tasks that involve no exposure to blood, body fluids or tissue but employment may require performing unplanned Category 1 tasks. The normal work routine involves no exposure to blood, body fluids or tissue but exposure or potential exposure may be required as a condition of employment. Appropriate protective measure should be readily available.

Category 3 : Performs tasks that involve no exposure to blood, body fluids or tissue and Category 1 tasks are not a condition of employment. The normal work routine involves no exposure to blood, body fluid or tissues.

Children’s Clinics reserves the right to make changes to this document at any time in accordance with business needs. This document is not intended to list all duties of the job. It is descriptive only of the chief duties and responsibilities. Employment is at-will.