Job Description
The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters . This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland’s policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered.
Responsibilities
1. Code, abstract and conduct charge quality review on all episodes of care on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS) and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines & hospital policy, analyzing questionable documentation to ensure to the accuracy of information & resolves identified issues.
2. Assigns appropriate diagnosis and procedures codes utilizing ICD 10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to the Centers for Medicare & Medicaid Services (CMS) requirements for both professional and hospital billing. May assist in training and reviewing the work of other coders for accuracy and efficiency.
3. Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
4. May verify, edit and/or enter charges based on documentation or payer/billing requirements reporting any discrepancies in a timely manner.
5. Updates, as appropriate, patient database with classification codes and resolves conflicts or inconsistencies to provide sufficient patient health information according to Parkland’s standards.
6. Stays abreast of the latest developments, advancements, and trends in the field of health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrates knowledge gained into current work practices.
7. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
8. Facilitate a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work related encounters are productive.
9. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the Coding area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.
10. Maintains CE hours and renew annual coding credentials.
11. This position is 100% Virtual. Virtual employees must also comply with all Parkland policies and procedures governing the use of Parkland information resources. Virtual employees must maintain all equipment lent by Parkland for performing the agreed upon job duties in good working condition. All employment responsibilities and conditions in applicable Parkland policies and procedures apply to employees while working virtually.
Submission Requirements
Profile Requirements:
At ThreePDS, our mission is to provide the highest quality staffing solutions on contract and/or permanent basis within the framework of a highly personalized and transparent approach. We Partner with Clients and Candidates alike to provide the highest level of service to achieve a common goal.
At ThreePDS, our mission is to provide the highest quality staffing solutions on contract and/or permanent basis within the framework of a highly personalized and transparent approach. We Partner with Clients and Candidates alike to provide the highest level of service to achieve a common goal.
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