Coding Integrity Specialist II, Work from Home in Orange Park, FL at Parallon

Date Posted: 4/5/2018

Job Snapshot

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Job Description

Coding Integrity Specialist (CIS) II, Work from Home

Job Summary – Reviews and evaluates hospital outpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes. Performs coding and/or code validation across multiple entities. Applies all appropriate coding guidelines and criteria for code selections. Adheres to Company and HSC Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedures.

Supervisor – Coding Manager

Duties (included but not limited to): 
• Using, ICD-10-CM and/or HCPCS/CPT, primarily assigns, validates, and/or edits codes the following patient types:

 - Same day surgery (SDC)

 - Observation (OBV)
 - Wound Care
 - Outpatient Cardiac Cath
• As needed, may also assign, validate, and/or edit codes for the following patient types:
 - Emergency department (ED) 
 - Recurring (RCR)
 - Clinical (CLI) records, and/or

 - Provider Office Visit (POV)
• Assigns, validates, and/or edits procedure categories, modifiers (when applicable)
• Maintains or exceeds established productivity standards
• Maintains or exceeds established accuracy standards
• Initiates, validates, and/or edits physician queries in compliance with Company and HSC policy where appropriate
• As needed, may periodically be asked to perform Coding Account Resolution Specialist II and/or I (CARS II and I) duties
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
• Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes
• Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes
• Meets all educational requirements as stated in current Company and HSC policy
• Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”
• Other duties as assigned

Job Requirements

• Coding Technical Skills- ICD-10-CM, HCPCS/CPT-4, and APCs.
• Analytical Skills – effective evaluation, synthesis and use of information gathered.
• Organization – establishing courses of action to ensure that work is completed efficiently; proactively prioritizes assignments and keen ability to multi-task.
• Communication - communicates clearly and concisely.
• Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures and systems.
• PC Skills - demonstrates proficiency in Microsoft Office applications and others as required.
• Quality Orientation – accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
• Work Independently – is self-supporting; not needing to rely on others to complete a job.

• High School graduate or GED equivalent required, undergraduate (associate or bachelors) degree in HIM/HIT preferred.

• One (1) year acute care observation and/or same day surgery hospital outpatient coding experience required.


• RHIT, RHIA or CCS preferred.