Coding Review Specialist - HIM- Days - FT

The Coding Review Specialist is responsible for daily auditing, monitoring, and follow-up to ensure coding compliance. The Specialist assigns appropriate codes to patient diagnosis and procedures and provides support to the coding staff. The Specialist monitors and documents coding trends.

Education:

High School or GED Experience:

4 years as a medical coder for an acute care facility

Skills:

Analyzing and organizing technical data Multitasking, time-management, and organization Verbal and written communication Responsible for performing coding compliance review Audits clinical documentation and coded data to validate documentation services rendered for reimbursement and reporting purposes Identifies discrepancies and billing issues; recommends a plan of action to correct discrepancies and prevent future coding errors Assures that accounts are grouped to the appropriate classification utilizing ICD diagnosis and procedure codes Reviews accounts assigned to work queue to determine if a clinical association exists for possible combined billing referencing various rules and regulations Monitors and reports the outstanding account reviews to facilitate account billing Ensures compliance with established guidelines and regulatory requirements Serves as a resource and subject matter expert to coding staff and interdisciplinary teams Assists in coordinating external third party annual coding audits Works with medical and business office staff to resolve coding issues and associated problems Serves as a liaison to Revenue Cycle to provide effective communication of concerns between Patient Financial Services and Coding Management Assigns ICD and CPT codes to patient diagnoses and procedures Ensures assignment of codes are consistent with coding guidelines and regulations Assigns Ambulatory Payment Classification (APC) promptly and accurately Groups patient diagnostic information according to regulations utilizing ICD diagnosis and procedure codes Enters coded and abstracted data into the hospital information system