Coding Specialist​/Michigan Residents

Overview

Under established coding principles and procedures, reviews, analyzes, and validates the diagnostic and/or procedural codes applied from front-end coding and clinical teams for reimbursement and billing purposes. The CBO Coding Certified Specialist accurately abstracts information from the electronic health record for compilation of a patient database, which supports medical research projects, patient care evaluation, and administrative decision making related to patient care.

The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, and regulation and accreditation guidelines.

• Review, analyze, and validate diagnostic and/or procedural codes for reimbursement and billing.
• Accurately abstract information from the electronic health record for patient databases supporting research, evaluation, and administrative decision making.
• Ensure compliance with coding guidelines, third party reimbursement policies, and regulatory/accreditation standards.
• Contribute to provider/patient continuity and accurate database information to optimize reimbursement.
• Support coding accuracy and escalate issues as needed to supervisors for root-cause analysis.
• Assist other team members and work to standards set forth in the HFHS Code of Conduct by adhering to legal and ethical guidelines.

• Education/Experience Required
• High school diploma or G.E.D. equivalent required.
• Billing or coding experience preferred.
• Some college or coursework in Accounting, Business, Healthcare Administration, or Medical Record Sciences preferred.
• Prior experience in a healthcare revenue cycle position preferred.
• Thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
• Six (6) months prior coding experience preferred, but not required.
• Strong organizational and time management skills; ability to prioritize work.
• Effective communication with colleagues, supervisor, and manager; ability to work independently and remotely.
• Proficiency in medical terminology and ICD-10-CM, CPT, and HCPCS coding.
• Ability to recognize patterns and trends and escalate to supervisors to support root-cause analysis; willingness to assist other team members.
• Adherence to HFHS Code of Conduct and legal/ethical guidelines.

• Certifications/Licenses Required
• Certification as a Registered Health Information Technician (RHIT), RHIT Certification eligibility, or CPC, CPC-A, CCS, CCP, or CCA certification required.

• Organization:
  Corporate Services
• Department: CBO Coding PB
• Shift: Day Job
• Union Code:
  Not Applicable