Coding Quality Assurance Specialist II

Coding Quality Assurance Specialist II

We're searching for a Coding Quality Assurance Specialist II someone who works well in a fast-paced setting. In this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. Ascertains the accuracy of the physicians' E/M and procedure coding to their documentation, completes the auditing reporting tool, and provides feedback to the education team and/or provider.

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Job Duties & Responsibilities

• Assigns ICD-10-CM, ICD-10-PCS, and CPT codes.
• Reviews and interprets documentation for appropriate diagnosis and procedures.
• Communicates with and provides feedback to the education team and/or provider.
• Identifies principle and secondary diagnoses and procedure codes from the electronic medical and/or paper record.
• Utilizes the encoder or coding books to correctly assign all ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
• Sequences diagnosis and procedures to generate appropriate ICD-10-CM, CPT, PCS, and DRG codes for billing.
• Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
• Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, Logician, and coding reference materials).
• Assists other coders in resolving coding problems/questions.
• Provides ICD-10 and CPT, for physician research projects, and reporting purposes.
• Completes abstracts for records when appropriate.
• Identifies problem accounts.
• Corrects problem accounts.
• Participates in education and maintains certification.
• Assists in auditing records.
• Maintains concurrent coding for inpatient records.

Skills & Requirements

• Required H.S. Diploma or GED

Required Licenses/Certifications

• CCA - Certified Coding Associate by the American Health Information Management Association (AHIMA)
• CCS - Cert-Cert Coding Specialist by the American Health Information Management Association (AHIMA)
• CCS-P - Cert-CCS-P Physician Based by the American Health Information Management Association (AHIMA)
• CIPC - Certified Inpatient Coder by the American Academy of Professional Coders (AAPC)
• COC - Certified Outpatient Coder by the American Academy of Professional Coders (AAPC)
• CPC - Cert-Cert Professional Coder by the American Health Information Management Association (AHIMA)
• CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC)
• RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA)
• RHIT - Cert-Reg Health Inform. TECH by the American Health Information Management Association (AHIMA)
• Required 2 years' experience in coding

Texas Children's Hospital