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Virtual Coding Integrity Specialist I in Nashville at Parallon

Date Posted: 1/3/2019

Job Snapshot

  • Employee Type:
  • Location:
  • Job Type:
  • Experience:
    At least 3 year(s)
  • Date Posted:

Job Description

The Coding Integrity Specialist I reviews and evaluates hospital outpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes. The specialist performs coding and/or code validation across multiple entities and applies all appropriate coding guidelines and criteria for code selections. The specialist adheres to Company and HSC Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedures. 
Duties (included but not limited to):
• Using ICD-10-CM and/or HCPCS/CPT, assigns, validates, and/or edits codes for the following patient types:
o Emergency room (ED), 
o Recurring (RCR) excluding Wound Care and Cardiac Cath, and
o Clinical (CLI) records
o Provider Office Visit (POV) 
• Assigns, validates, and/or edits the ED E/M levels, and enters and/or validates charges for ED, OB ED and/or observation (OBV) infusions and/or injections 
• Assigns, validates, and/or edits procedure categories and modifiers 
• Maintains or exceeds established productivity standards 
• Maintains or exceeds established accuracy standards 
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current 
• Meets all educational requirements as stated in current Company and HSC policies 
• 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 
• Initiates, validates, and/or edits physician queries in compliance with Company and HSC policy when appropriate 
• As needed, may periodically be asked to perform Coding Account Resolution Specialist I (CARS I) duties
• 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.
• Where applicable, demonstrates proficiency in ACEP E/M level assignment, and the application of injection and infusion hierarchy.
• 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.
• Analytical skills – effective evaluation, synthesis and use of information gathered.
• 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's or Bachelor's) degree in HIM/HIT preferred.
• 1-year acute care outpatient coding experience required with 3 years’ healthcare experience strongly preferred. 
• RHIT, RHIA or CCS preferred.