The HIS Professional Coding Integrity Specialist II is responsible for assigning diagnosis and procedure codes to patient accounts using ICD and CPT classification systems as appropriate. This role focuses on Same Day Surgery, Observation, and Specialty accounts, and may also include inpatient accounts. Proficiency is required in Emergency Department and outpatient clinical coding as workload requires.
Additional responsibilities include abstracting accounts, resolving claim edits, researching coding issues, querying physicians for clarification, and participating on the coding team to ensure the highest quality coded data. The role supports accurate reimbursement, quality reporting, and compliance through precise translation of clinical documentation into coded data.
- 2–3 years of prior coding experience or satisfactory completion of an internal coding assessment
- Knowledge of medical terminology, anatomy and physiology, disease processes/pathophysiology, and pharmacology
- Knowledge of coding guidelines, ICD diagnosis and procedure coding, CPT/HCPCS coding, and CPT Assistant
- Knowledge of coding ethics
- CCA, CPC, or CCS certification required within 9 months of hire
- Strong interpersonal, verbal, and written communication skills
- Strong organization and time management skills
- Familiarity with computers and common software applications, including MS Office, internet, EHR systems, and encoder software
- Ability to meet productivity and quality standards
Preferred qualifications:
- Prior coding experience in ambulatory and acute care
- RHIA or RHIT preferred
- Clinical queries/documentation improvement knowledge preferred
- Knowledge of Coding Clinic, regulatory/compliance issues, and reimbursement methodologies preferred
- Training and mentoring capacity preferred
Location
Ohio, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago