Responsible for monitoring, assessing, and improving the quality of coding processes, documentation, and adherence to coding guidelines and regulations by enhancing coding accuracy, minimizing errors, and promoting coding compliance.
Essential Functions:
-Ensure coding practices align with official coding conventions, guidelines, and regulatory requirements set forth by organizations such as the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other relevant bodies.
-Analyze medical records, physician notes, and other relevant documentation to assess the adequacy and specificity of documentation supporting the assigned codes.
-Identify opportunities to streamline coding workflows, enhance efficiency, and improve coding accuracy.
-Establish key quality metrics and reporting mechanisms to monitor and track coding accuracy, productivity, and compliance.
-Foster effective communication and collaboration with healthcare providers, coders, clinical documentation improvement specialists, billing staff, and other stakeholders to address coding-related inquiries, clarify documentation requirements, and resolve coding issues.
Experience
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5+ years of medical coding experience required
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1+ years of quality assurance experience preferred
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Strong inpatient coding experience, academic facility preferred.
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Must have ICD-10 PCS coding experience
Knowledge, Skills and Abilities
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Advanced knowledge of medical coding systems, including ICD-10 CM and PCS.
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Knowledgeable of coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations.
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Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes.
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Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding.
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Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff.
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Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
