Coding Specialist

The Coding Specialist position translates medical documentation into standardized codes for billing, claim processing, and data analysis. This position is a senior level, mentoring position for other coders and requires individuals with significant experience and a high level of coding proficiency. This position requires the ability to analyze operative reports and assign surgical codes according to coding guidelines and payer requirements.

The Coding Specialist position translates medical documentation into standardized codes for billing, claim processing, and data analysis. This position is a senior level, mentoring position for other coders and requires individuals with significant experience and a high level of coding proficiency. This position requires the ability to analyze operative reports and assign surgical codes according to coding guidelines and payer requirements.

• Documentation Review:
  Analyze and interpret clinical documentation to ensure completeness and accuracy for coding purposes.
• Assign Codes:
  Assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses, procedures, and services based on clinical documentation and official coding guidelines.
• Validate Codes:
  Verify and correct codes recommend by Computer-Assisted Coding (CAC) software.
• Utilize Coding Guidelines:
  Research and utilize all current coding guidelines for appropriate code assignment; including but not limited to AHA Coding Clinic, CPT Assistant, federal regulations, CCI coding initiatives, Official Guidelines for ICD-10 and CPT, insurance payer guidelines and Trinity Health internal coding guidelines.
• Collaboration:
  
  Work with healthcare providers/team to clarify inadequate, ambiguous, or unclear documentation to resolve coding discrepancies.
• Workflow and Processes:
  Follow established workflows and processes to ensure efficiency and productivity.
• Coding Claim Edits:
  Review, resolve, and process coding claim edits to ensure clean claim submission.
• Productivity:
  Maintain acceptable productivity rate according to established coding benchmarks based on type of work.
• Quality:
  Maintain acceptable quality rate at 95% or higher.
• Confidentiality:
  Ensure strict confidentiality of healthcare and financial records by following Trinity Health policies related to Compliance, Privacy and Security.
• Teamwork:
  Engage as a team player and assist others as needed.