Coding Specialist I Inpatient Medicine

Job Posting Closing Date: Open until Filled

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional, at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture, outstanding benefits and competitive compensation package is best in class.

Job Description

The Coding Specialist I is an entry level HM professional fee coder with less than 24 months of HM professional coding experience. Coding Specialist utilize critical thinking skills in evaluating medical necessity in regulatory policies. Apply knowledge of official coding guidelines and other regulatory guidelines through assignment of compliant, complete, and accurate ICD-10-CM diagnosis codes and CPT service codes for the professional component of rendered services based upon the clinical documentation provided within the medical record. Works collaboratively with other members of the Coding, Coding Quality and Clinician Education team to complete all essential responsibilities in a timely fashion to meet the quality, utilization, and financial needs of the organization.

  • ESSENTIAL JOB FUNCTIONS:
  • Examines medical records to determine the proper ICD (diagnosis) and CPT (procedure codes) to be assigned
  • Utilizes coding tools & resources to verify the correctness of CPT and ICD codes assigned.
  • Abstracts data including providers, injury info, quality measures, and others as needed.
  • Maintains knowledge of current trends and practices in coding principles and government regulations through reading materials and/or attendance at educational meetings or seminars.
  • Maintains appropriate certification.
  • Communicates with coworkers and physicians to resolve and clarify questions and documentation discrepancies.
  • Communicates risk management concerns to appropriate parties
  • Completes priority accounts (Holds) daily.
  • Refers complex issues to designated work queues.
  • Participates in coder specific training and education based on audit metrics and trends.
  • Review and analyze content of medical record to accurately assign ICD diagnosis and procedure codes; CPT procedure codes and modifiers according to national coding guidelines, USACS policies and SOPs.
  • Answer coding and abstracting questions from coding leadership, compliance, clinicians, etc.
  • Maintain coding accuracy rate of ≥ 95%.
  • Maintain coding productivity (Milestone based standards) rate of ≥ 95%.
  • Maintain minimum of 15 CEUs per quarter either through Nthrive and/or other company sponsored webinars and programs.
  • Accurately identify and enter core abstracting elements such as physician and APP attributions.
  • Identify documentation trends and topics for education/feedback to physicians and APPs.
  • Keep current with coding and industry changes through participation in educational opportunities.
  • Thorough understanding of updates from intermediaries, carriers, government agencies, third party payers to ensure proper documentation, coding and compliance.
  • Thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payor specific guidelines.
  • Assists with special projects as needed and performs related duties as assigned.
  • KNOWLEDGE, SKILLS AND ABILITIES:
  • Knowledge of and experience using ICD and CPT coding.
  • Knowledge of payor guidelines.
  • Knowledge of and skill in using personal computers in a Windows environment with an emphasis on basic word processing and data entry.
  • Ability to work independently and make decisions.
  • Ability to pay close attention to detail.
  • Ability to identify research and solve problems and discrepancies.
  • Ability to communicate with employees, management and physicians in a courteous and professional manner.
  • Ability to maintain confidentiality.
  • Ability to process assigned duties in an organized manner.
  • EDUCATION AND EXPERIENCE:
  • High school diploma or equivalent.
  • One or more of the following credentials are required prior to hire date - Certified Coding Specialist (CCS), Certified Professional Coder (CPC-A), Certified Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist – Physician-Based (CCS-P).
  • PHYSICAL DEMANDS:
  • While
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