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Coding Specialist I

Job Overview

UnityPoint Health Information

Overview

Coding Specialist I

Dubuque, IA

Monday-Friday 8:00AM-5:00PM

Full Time Benefits

Coding Specialist I review inpatient and outpatient medical records for documentation, abstracting and analyzing. Coders assign all codes to the highest level of specificity following the current guidelines for ICD-10-CM, CPT and, HCPCS. With the ability to understand and properly apply modifiers, CCI edits, medical policy rules (e.g., LCD/NCD), etc. in compliance with payor regulations.

Responsibilities

Coding and Department Support

• Assigns procedural codes according to coding conventions defined by the American Medical Association’s CPT manual, CMS, including the Correct Coding Initiative, Medicaid and other third-party payor policies as applicable.
• Assigns diagnosis codes according to the ICD-9 and/or ICD-10 Official Guidelines for Coding and Reporting.
• Research and resolve coding related issues accordingly per established EPIC Charge Review Work Queue functionality.
• Attend clinic/provider meetings as necessary per the Coding Supervisor and/or the Operations Coding Manager.
• Maintain quality scores at or above 95%.
• Collaborate with Clinical Auditors to identify opportunities for improvement and provide guidance/counsel to providers
• Review and analyze medical billing and coding for clinic claims.
• Review and accurately verify coding for services and reimbursement in compliance with CPT and ICD guidelines as well as using appropriate modifiers and HCPC codes.
• Ensure that all codes are current and active.
• Report missing or incomplete documentation.
• Assist with insurance and coding questions, conduct research as needed.
• Communicate effectively and directly with clinical staff

Qualifications

Education

High-School diploma/GED.
Completion of nationally recognized coding program (AHIMA/AAPC)

Experience

Knowledge of ICD-9/ICD-10 diagnosis, Current Procedural Terminology (CPT) and HCPCS codes required

License(s)/Certification(s)

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC) current certification status required within one year of hire

Knowledge/Skills/Abilities

• Knowledge of medical terminology, anatomy, and physiology

• Strong interpersonal and communication skills

• Ability to work as a team member

• Knowledge of medical billing and third party reimbursement policies preferred.

• Strong computer skills

• Strong verbal and written communication skills