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Parkland Health

Coding Specialist II

Parkland Health, Dallas, Texas, United States, 75215

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Coding Specialist II

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Parkland Health . Outpatient Experience Needed. Remote must live in TX, AR, FL or WI. Primary Purpose

The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting, and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters. This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland’s policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered. Education

High school diploma required. Must have successfully completed an approved coding program. OR must be a graduate of a Health Information Management program. Must have strong knowledge of Anatomy and Physiology and possess strong application skills. Experience

Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties. Physician office coding, charging, and billing experience preferred. Equivalent Education And/or Experience

May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above. Certification/Registration/Licensure

Must be certified through the American Health Information Management Association (AHIMA) 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 Professional Coder-Hospital (CPC-H) Certified Outpatient Coder (COC) Skills Or Special Abilities

Advanced coding and charge review skills, understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations. Advanced knowledge of ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage for hospital and professional billing. Score a minimum of 80% on a pre-employment 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. Demonstrate proficiency in coding and encoder skills. Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC). Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred. Responsibilities

Code, abstract and conduct charge quality review on all episodes of care on ED, SDS, OPC, OBS and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines, and hospital policy, analyzing questionable documentation to ensure accuracy of information and resolve identified issues. Assign appropriate diagnosis and procedures codes utilizing ICD-10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to CMS requirements for both professional and hospital billing. May assist in training and reviewing the work of other coders for accuracy and efficiency. Aim to achieve and maintain 95% accuracy on quality reviews and assigned productivity standards. Verify, edit and/or enter charges based on documentation or payer/billing requirements, reporting discrepancies in a timely manner. Update patient database with classification codes and resolve conflicts or inconsistencies to provide sufficient patient health information according to Parkland’s standards. Stay abreast of the latest developments, advancements, and trends in health information management by attending workshops, reading professional journals, participating in professional organizations, and applying knowledge to current practice. Identify ways to improve work processes and customer satisfaction. Make recommendations to supervisor, implement and monitor results as appropriate in support of department and Parkland goals. Facilitate positive working relationships with physicians, nurses, and medical staff to ensure productive encounters. Maintain knowledge of applicable rules, regulations, policies, laws and guidelines impacting the Coding area. Develop internal controls to promote adherence to laws, accreditation requirements, and payer guidelines. Seek guidance as needed. Maintain CE hours and renew annual coding credentials. Job Accountabilities

Identify ways to improve work processes and customer satisfaction. Make recommendations, implement and monitor results in support of department and Parkland goals. Stay abreast of developments and trends in the field, attending seminars/workshops, reading journals, participating in professional organizations, and maintaining certification or licensure. Integrate knowledge into practice. Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the area. Develop internal controls to promote adherence with applicable laws and requirements. Seek guidance as needed. 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. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus. Seniority level

Mid-Senior level Employment type

Full-time Job function

Health Care Provider Industries

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