Medical Coder​/Coding Specialist

Employee Type:

PRN

Work Shift:

Day – 8 hour shift (United States of America)

Join Team Tidelands and help people live better lives through better health!

Medical Coder/Coding Specialist II

Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region’s largest health care provider, we are also one of our area’s largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day.

Medical Coder II is responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to all outpatient, ED, and hospitalists accounts, both facility and professional, based on the medical information provided and consistent with regulatory guidance and best practices in the industry and organizations policy and procedure. Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC.

Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes work to meet deadlines and goals. Maintains and expands knowledge of coding and sequencing guidelines to ensure coding compliance and accuracy. Responsible for resolving coding edits, account checks, rejections, and denials to ensure proper reimbursement of service rendered and to maintain an industry standard clean claim rate.

May assist with writing appeals letters. Assist with training to include team members and physicians.

• Analyzes medical records, interprets documentation, and assigns proper ICD 10 CM, CPT/HCPCS, modifiers, and E&M codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required.
• Enters charges for procedures that are not soft coded as instructed for certain patient types. Codes complex diagnostic and procedural accounts.
• Completes a daily basis cases that has been assigned to them utilizing the appropriate work lists/work queues.
• Works closely with Patient Financial Service (PFS) to review documentation and serve as department expert on coding questions. Assist Patient Financial Service (PFS) with written appeal letters, dispute determination responses, and redetermination to support reimbursement of services rendered.
• Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
• Review and resolve account checks, clearinghouse rejection errors, denials, and charge review/claim edits daily. Also reviews accounts returned from various departments and processes corrections for clean claim submission or posts claim denial review for appeal.
• Collaborate with the Compliance/Quality Team when alerted to coding quality issues found via internal or external reviews; implement with accuracy coding quality recommendations.
• Work with HIM operations as needed to clarify queries and documentation needs for the completion of the medical record.
• Verify accurate abstracting of discharge disposition.
• Assist in training new coders to become acclimated to the environment and in understanding internal coding policies and procedures, and documentation guidelines.

• High School Diploma or equivalent Preferred

• Minimum of two years of progressive on-the-job coding experience in an acute care hospital or physician’s office or successful completion of Tidelands Health coding cross-training program

• Analyze clinical data and interpret information.
• Have knowledge of payer guidelines related to MUE, Medical Necessity, LCD/NCD requirements and HIPAA/Compliance.
• Ability to assign ICD-10-CM, CPT and/or HCPCS codes to complex diagnoses and procedures in an integrated system of outpatient and emergency records.
• Solid knowledge of hospital documentation, and coding workflows and terminology;
  Solid understanding of and ability to apply Coding Clinic and other coding guidelines.
• Proficient at writing AHIMA-compliant physician queries.
• Adept at comparing documentation,…