Job Description

Job description

Responsible for completing Inpatient & outpatient coding accuracy reviews to ensure the client coding team members are coding accurately according to the documentation within each record.

Responsibilities

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes and other abstracted data, such as discharge disposition. Ensure accurate coding for outpatient, day surgery, and inpatient records. Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic, and national and local coverage decisions.

In this role, you will work closely with our Symbion Coding leadership, following their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs and DRGs. This collaborative approach is crucial to ensure compliance in all areas of coding.

Qualifications

• Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA) in conjunction with Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA) or Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA).
• Accepting U.S. applicants only
• This position typically requires 5 years of QA experience in hospital coding for a large, complex healthcare system, including hospital coding, denial review, and/or coding quality review functions.

Knowledge, Skills & Abilities

• Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups).
• Advanced knowledge of Microsoft Applications, including but not limited to Excel, Word, PowerPoint, and Teams.
• Advanced knowledge and understanding of anatomy and physiology, medical terminology, and pathophysiology (disease process, surgical terminology, and pharmacology.)
• Advanced knowledge of pharmacology indications for drug usage and related adverse reactions.
• Expert knowledge of coding workflow and optimization of technology, including how to navigate electronic health information records and health information management and billing systems.
• Excellent communication and reading comprehension skills.
• Demonstrated analytical aptitude, with a high attention to detail and accuracy.
• Ability to take initiative and work collaboratively with others.
• Experience with remote workforce operations is required.
• Ability to work independently
• Strong sense of ethics.

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