Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, reporting, and compliance with Official Coding Guidelines, payer regulations, and hospital policy. Educates physicians and clinical staff to ensure complete documentation in medical records and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Trains coders to develop coding and reimbursement knowledge and career advancement, including creating training materials and reference documents. Researches audit results, error reports, and denials; resolves issues by appeal, education, and correcting discrepancies.
General working conditions include a well-lit, air-conditioned environment with moderate noise; task changes without loss of efficiency; occasional high stress and fluctuating workloads; possible overtime as scheduled.
Education required: Bachelor's degree in Health Information Management or related medical degree; alternatively, Associate degree plus 4 years relevant experience.
Experience: 4-5 years with ICD-9, ICD-10, and HCPCS coding in hospital inpatient records; extensive knowledge of medical terminology, pathophysiology, pharmacology; experience with MS-DRG, DRG, APC, and payer reimbursement methodologies.
Certifications: Certified Coding Specialist (CCS) required; preferred Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer.
Skills: organizational, communication, interpersonal, customer relations, mathematical, analytical, grammar/spelling, reading and following instructions, basic computer and Microsoft Office skills, general clerical skills.
Physical demands include mostly sitting during shift, with occasional standing, walking, bending, twisting, pushing/pulling, and reaching.
- Bachelor's Degree in Health Information Management or related medical degree (or Associate Degree plus 4 years relevant experience)
- 4-5 years experience with ICD-9, ICD-10, HCPCS coding in hospital inpatient medical records
- Extensive knowledge of medical terminology, pathophysiology, and pharmacology
- Experience analyzing MS-DRG, DRG, APC, and payer reimbursement methodologies
- Certified Coding Specialist (CCS) required
- Preferred certifications: RHIT, RHIA, AHIMA Approved ICD-10 Trainer
- Strong organizational, communication, interpersonal, analytical, and computer skills
Location
Georgia, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 month ago