Coding Quality Assurance Specialist I

Coding Quality Assurance Specialist I

We're searching for a Coding Quality Assurance Specialist I -- 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. The position also ascertains the accuracy of the physicians' E/M and procedure coding, completes the auditing reporting tool, and provides this feedback to the education team and/or provider.

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Job Duties & Responsibilities

Assigns ICD-10-CM and CPT codes.

Reviews documentation in records to appropriately assign ICD-10-CM, PCS, and CPT codes.

Communicates with and provides feedback to the education team and/or provider.

Utilizes the encoder or coding books to correctly assign all appropriate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.

Sequences diagnosis and procedures to generate appropriate DRGs for billing in accordance with the Coding Guidelines based on the type of coding.

Queries physicians to obtain clarification or missing elements in the record preventing correct coding.

Utilizes available resources for assignment of codes as necessary (e.g., Diagnostic Imaging system, Lab system, Emergency Center system, Cardiac Cath system, Epic, and coding reference books).

Inputs codes into the Epic computer system utilizing the Encoder.

Completes abstracts if appropriate.

Identifies problem accounts.

Assists in correction of problem accounts.

Participates in education and maintains certification.

Maintains concurrent coding for all records.

Skills & Requirements

Required H.S. Diploma or GED

Required Certifications

LCCA - Certified Coding Associate

CCS - Cert-Cert Coding Specialist

CCS-P - Cert-CCS-P Physician Based

CIPC - Certified Inpatient Coder

COC - Certified Outpatient Coder

COC-A - Cert Outpat Coder - Apprentice

CPC - Cert-Cert Professional Coder

CPC-A - Cert Prof Coder - Apprentice

CRC - Cert Risk Adjustment Coder

RHIA - Cert-Reg Health Infm. Admins

RHIT - Cert-Reg Health Infm. TECH

Required 1 years' experience as a coder

Texas Children's Hospital