Him Certified Coding Specialist

JOB SUMMARY

Accountable for conversion of diagnoses and treatment procedures into codes using an international classification of diseases. Requires skill in the sequencing of diagnoses/procedures to optimize reimbursement. Ensures that records are coded in an accurate and timely manner, while strictly adhering to the AHIMA Code of Ethics.

• Reviews chart thoroughly to ascertain all diagnoses and procedures.
• Professional communication with colleagues.
• Ensures coding aligns with documentation and proactively queries physicians for clarification.
• Uses coding/abstracting software and codes all diagnoses/procedures in accordance with ICD‑10‑CM/PCS, HCPCS, and CPT coding and payer guidelines, fully addressing CCI edits.
• Maintains 95% accuracy in principal and secondary diagnoses, procedures, and modifiers.
• Reviews coding periodicals within seven days of receipt and maintains CEU requirements.
• Verifies and corrects all coding errors and denials; reports back to the director when work is more than 48 hours behind deadline.
• Assists the director with state reporting requirements and ensures data quality and optimal reimbursement.
• Provides coding education to hospital staff and serves as a resource for coding changes and issues.

• High school graduate or equivalent.
• One or more years of previous experience as a medical coder.
• Knowledge of billing and coding in accordance with ICD‑10‑CM/PCS, HCPCS, and CPT coding principles for rural health clinics, critical access hospitals, and skilled nursing facilities.
• Ability to work collaboratively with physicians.
• Must hold a valid coding certification (CPC, CCA, CCS, CCS‑P, or equivalent). Five years of experience may be considered in lieu of certification.