SENIOR CODING SPECIALIST II – Remote Job Opportunity

When you join the SMH team, you are aligning yourself with an organization whose values drive our quality care in our community for the past 60 years. SMH has an exciting opportunity for a remote PRN Senior Coding Specialist to join our team. The ideal candidate has experience in inpatient, ambulatory surgery and observation facility coding.

POSITION SUMMARY:

The Senior Coding Specialist will code all patient types as needed; inpatient, same-day surgery and observation encounters. Must be proficient with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM/PCS codes and for hospital services.

KEY RESPONSIBILITIES:

• Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs.
• Codes complex outpatient and inpatient encounters utilizing encoder software in the assignment of ICD-10-CM/PCS, CPT/HCPCS codes, MS-DRG, APR-DRG, POA, SOI, ROM assignments, APC assignment and all required modifiers.
• Validates charges by comparing charges with health record documentation as necessary.
• Communicates effectively with clinical staff, physicians, office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
• Generate physician queries to clarify ambiguous, incomplete or conflicting documentation utilizing AHIMA’s Code of Ethics.
• Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems.
• Tracks issues (i.e. missing documentation, charges and physician queries) that require follow-up to facilitate coding in a timely fashion.
• Consistently meets or exceeds coding quality and productivity standards established by coding department.
• Adheres confidentiality requirements as they relate to release of any individual or aggregate patient information.
• Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.
• Maintains working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

• Extensive comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding and MS-DRG or APC grouping.
• Experience utilizing encoding/grouping software and EMR systems.
• Ability to use standard desktop and windows based computer system, including basic understanding of email, internet, and computer navigation.
• High ethical standards.
• Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines.
• Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters.
• Knowledge of documentation regulations of Joint Commission and CMS.
• Knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices.
• Strong analytical abilities and problem-solving skills.
• Excellent oral, written and interpersonal communication skills.
• Ability to organize and set priorities to ensure objectives are met in a timely manner.
• Ability to adapt to change and handle challenges proactively and with pose.
• Ability to effectively collaborate with physicians and managerial staff at all levels.

EDUCATION/EXPERIENCE/LICENSURE:

• Education: Completion of an American Health Information Management Association (AHIMA) approved coding program or an American Academy of Professional Coders (AAPC) approved coding program, or Associate degree in health information management or related field or an equivalent combination of years of education and experience required.
• Experience: Minimum three (3) years of current complex outpatient and inpatient coding required.
• Certification/Licensure: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Certified Professional Coder (CPC) from American Health Information Management Associations (AHIMA) or American Academy of Professional Coders (AAPC) required.

Registered Health Information Administrator (RHIA)/Technician (RHIT) certification preferred.

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Vision insurance

Schedule:

• Monday to Friday

License/Certification:

• Medical Coding Certification (Required)

Work Location:

• Remote