Texas Children's Hospital
Professional Coding Quality Assurance Specialist II
Texas Children's Hospital, Houston, Texas, United States, 77246
Job Description
We’re searching for a Coding Quality Assurance Specialist II — someone who works well in a fast‑paced setting. In this position, you will assign and audit the accuracy of the ICD‑10‑CM and CPT codes to ambulatory, emergency center, observation, and day‑surgery records for purposes of billing, research, and providing information to government and regulatory agencies.
Ascertains the accuracy of the physicians' E/M and procedure coding to their documentation, completes the auditing reporting tool, and provides feedback to the education team and/or provider.
Job Duties & Responsibilities
Assigns ICD-10-CM, ICD-10-PCS, and CPT codes.
Reviews and interprets documentation for appropriate diagnosis and procedures.
Communicates with and provides feedback to the education team and/or provider.
Identifies principal and secondary diagnoses and procedure codes from the electronic medical and/or paper record.
Utilizes the encoder or coding books to correctly assign all ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
Sequences diagnosis and procedures to generate appropriate ICD-10-CM, CPT, PCS, and DRG codes for billing.
Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, Logician, and coding reference materials).
Assists other coders in resolving coding problems/questions.
Provides ICD‑10 and CPT for physician research projects, and reporting purposes.
Completes abstracts for records when appropriate.
Identifies problem accounts.
Corrects problem accounts.
Participates in education and maintains certification.
Assists in auditing records.
Maintains concurrent coding for inpatient records.
Skills & Requirements
Required High School Diploma or GED
Required Licenses/Certifications
CCA – Certified Coding Associate (AHIMA)
CCS – Certified Coding Specialist (AHIMA)
CCS-P – Certified Coding Specialist, Physician‑Based (AHIMA)
CIPC – Certified Inpatient Coder (AAPC)
COC – Certified Outpatient Coder (AAPC)
CPC – Certified Professional Coder (AAPC)
CRC – Certified Risk‑Adjustment Coder (AAPC)
RHIA – Registered Health Information Administrator (AHIMA)
RHIT – Registered Health Information Technician (AHIMA)
Required 2 years’ experience in coding
Outpatient, Professional coding experience in the following specialties (highly desired): Plastics, Otolaryngology, Orthopedics
About Us Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children ’ s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children ’ s Hospital West Campus, a community hospital in suburban West Houston; Texas Children ’ s Hospital The Woodlands, the first hospital devoted to children ’ s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children ’ s Health Plan, the nation ’ s first HMO focused on children; Texas Children ’ s Pediatrics, the largest pediatric primary care network in the country; Texas Children ’ s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children ’ s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children’s without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Seniority level Entry level
Employment type Part‑time
Job function Quality Assurance
Industries Hospitals and Health Care
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Ascertains the accuracy of the physicians' E/M and procedure coding to their documentation, completes the auditing reporting tool, and provides feedback to the education team and/or provider.
Job Duties & Responsibilities
Assigns ICD-10-CM, ICD-10-PCS, and CPT codes.
Reviews and interprets documentation for appropriate diagnosis and procedures.
Communicates with and provides feedback to the education team and/or provider.
Identifies principal and secondary diagnoses and procedure codes from the electronic medical and/or paper record.
Utilizes the encoder or coding books to correctly assign all ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
Sequences diagnosis and procedures to generate appropriate ICD-10-CM, CPT, PCS, and DRG codes for billing.
Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, Logician, and coding reference materials).
Assists other coders in resolving coding problems/questions.
Provides ICD‑10 and CPT for physician research projects, and reporting purposes.
Completes abstracts for records when appropriate.
Identifies problem accounts.
Corrects problem accounts.
Participates in education and maintains certification.
Assists in auditing records.
Maintains concurrent coding for inpatient records.
Skills & Requirements
Required High School Diploma or GED
Required Licenses/Certifications
CCA – Certified Coding Associate (AHIMA)
CCS – Certified Coding Specialist (AHIMA)
CCS-P – Certified Coding Specialist, Physician‑Based (AHIMA)
CIPC – Certified Inpatient Coder (AAPC)
COC – Certified Outpatient Coder (AAPC)
CPC – Certified Professional Coder (AAPC)
CRC – Certified Risk‑Adjustment Coder (AAPC)
RHIA – Registered Health Information Administrator (AHIMA)
RHIT – Registered Health Information Technician (AHIMA)
Required 2 years’ experience in coding
Outpatient, Professional coding experience in the following specialties (highly desired): Plastics, Otolaryngology, Orthopedics
About Us Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children ’ s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children ’ s Hospital West Campus, a community hospital in suburban West Houston; Texas Children ’ s Hospital The Woodlands, the first hospital devoted to children ’ s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children ’ s Health Plan, the nation ’ s first HMO focused on children; Texas Children ’ s Pediatrics, the largest pediatric primary care network in the country; Texas Children ’ s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children ’ s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children’s without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Seniority level Entry level
Employment type Part‑time
Job function Quality Assurance
Industries Hospitals and Health Care
#J-18808-Ljbffr