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Coding Review Specialist - HIM- Days - FT

Memorial Health System

Job Description

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.

Responsibilities

  • 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
Qualifications

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
Vacancy posted 4 days ago
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