CODING SPECIALIST

Overview: Under supervision, to perform work involving the thorough examination and evaluation of medical record documentation to accurately assign ICD-10-CM, CPT 4, and HCPCS codes and to abstract relevant information from inpatient and outpatient records. Responsibilities: PRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)

1. Coding Standards and Guidelines: Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Completes HealthStream coding compliance task.
2. Coding: Applies the appropriate diagnostic and procedural codes to individual patient health information, for data retrieval, analysis, and claims processing utilizing computerized encoder and grouper.
3. Accuracy Standards: 100-95 = Exceeds Standards (5); 94-90 = Above Standards (4); 89-85 = Meets Standards (3); 84-80 = Improvement Needed (2); 79 and under (1) - Most work onsite with supervisor, until successful completion of a quarterly review with accuracy level at "meets standards".
4. Abstracting: Applies appropriate elements to record, including admitting provider, attending provider, other providers, point of origin, primary service, discharge destination, discharge disposition, present on admission.
5. Accuracy Standards: 100-90 = Exceeds Standards (5); 89-80 = Above Standards (4); 79-70 = Meets Standards (3); 69-60 = Improvement Needed (2); 59 and below: (1) must work on site, with supervisor, until successful completion of a quarterly review, with accuracy level at �meets standards�.
6. Coding Education Maintenance: Keeps abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department director for resolution, Completes educational credits according to applicable area.
7. Learning opportunity standard: 8 or more completed = Exceeds standards (5); 7-6 completed = Above standards (4); 5-4 completed = Meets standards (3); 3-2 completed = Improvement needed (2); 1-0 completed = Not meeting expectations (1).
8. Queries: Queries the appropriate discipline for additional or clarifying documentation to ensure the accuracy and completeness of coding and abstracting.
9. Teamwork: Shows initiative by providing input to better the department and/or hospital. Reviews MCC and CC list to identify opportunities for queries or documentation improvement.
10. Departmental Expectations: Attends departmental meetings (6 out of 12 monthly meetings minimum). Acknowledges minutes and handouts, when absent from meetings, by initialing e-mail within one week. Checks Methodist's internal e-mail when logging on for work, at mid-day, and before logging off.

KNOWLEDGE, SKILLS, AND ABILITIES

• Considerable knowledge of ICD-10 and CPT coding systems.
• Ability to work independently, and as part of a team collaborating with colleagues.
• Enthusiastic, motivated and positive attitude.
• Successful completion of a coding certificate program, with American Health Information Management Association (AHIMA) approval status, as RHIA, RHIT, CCS or CCA is required.

• High School Diploma/GED Equivalent Required
• Certificate Required
• 5 Healthcare/Medical - Medical Coding Preferred