of the Coding Specialist I is to code and verify data necessary to ensure correct coding, abstracting, billing on Community Oriented Primary Care (COPC), Outpatient Clinics (OPC), Maternal and Fetal Medicine (MFM) and Women and Infants Specialty Health (WISH) encounters. This position requires the coder to be highly proficient in the proper assignment/verification of evaluation and management (E/M), ICD-10 CM, CPT, HCPCS and modifier assignment.
Minimum Specifications Education:
High school diploma required
Must successfully completed an approved coding program OR Must be a graduate of a Health Information Management program.
Minimum Required Experience:
Three years of related experience required
Physician office coding experience preferred
Equivalent Education and/or Experience
Must have a Certified Coding Associate (CCA) certification OR
Must be certified through the American Health Information Management Association as one of the following:
- Registered Health Information Management Technician (RHIT)
- Registered Health Information Management Administrator (RHIA)
- Certified Coding Specialist (CCS)
- Certified Coding Specialist
- Physician Based (CCS-P) OR
Must be certified through the American Association of Procedural Coders (AAPC) as one of the following:
- Certified Professional Coder (CPC)
- Certified Outpatient Coder (COC)
- Certified Professional Coder Apprentice (CPC-A)*
- Certified Professional Coder-Hospital (CPC-H)
- Certified Professional Coder-Hospital Apprentice (CPC-H-A)* *If hired with CPC-A or CPC-H-A certification, employee must have apprentice designation removed from their certification within two years to continue in Coder I classification.
Required Tests for Placement
Skills or Special Abilities:
Must be able to demonstrate basic coding skills understanding the utilization of modifiers and other coding rules to include AMA and other coding organizations.
Must score a minimum of 70% on a pre-employment outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
Must have knowledge of medical terminology, the human disease process, anatomy and physiology.
Must be able to demonstrate an increased proficiency in coding and encoder skills within three (3) months of employment.
Must be able to demonstrate knowledge of computer software applications including MS office.
Must be able to effectively communicate, both orally and in writing.
1. Receives and codes all episodes of care for Community Oriented Primary Care (COPC), Outpatient Clinics (OPC), Maternal and Fetal Medicine (MFM) and Women and Infants Specialty Health (WISH) encounters according to coding guidelines and hospital policy.
2. Assigns appropriate evaluation and management (E/M) level, ICD 10-CM and/or CPT code to coding according to the Centers of Medicare & Medicaid Services (CMS) requirements.
3. Achieve and maintain 95% accuracy on quality reviews and productivity standards.
4. Verify, edit and/or enter charges based on documentation or insurance requirements reporting any discrepancies in a timely manner.
5. Updates, as appropriate, patient database with classification codes to provide sufficient patient health information according to Parkland¿s standards.
6. Stays abreast of the latest developments, advancements, and trends in the field of health information management by attending seminars/workshops, reading professional journals, actively participating in professional organizations and integrates knowledge gained into current work practices.
7. Identifies ways to improve work processes and improve customer (internal as well as external) satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
8. Facilitates a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work related encounters are productive.
9. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the Coding area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.
10. Maintains CE hours and renew annual coding credentials.
Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.
Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth
Job Segment: Medical, Physiology, Medical Coding, Patient Care, Medicare, Healthcare