Coding Specialist - Oceanport, NJ at RWJBarnabas Health – Oceanport, New Jersey

Required:

• Associate’s Degree

• Must have advanced coding education and training.

• Must have excellent interpersonal, oral, and written communication skills.

• Must have excellent organizational and time management skills.

• Must be able to work independently with minimal supervision.

Certifications and Licenses Required:

• CCS required

Preferred:

• Bachelor’s degree preferred.

• Prior coding supervisory experience and/or coding consultant experience preferred.

• CCS-P, CPC, CPC-H, RHIT, RHIA, and/or RN also encouraged.

Essential Functions:

• Reviews ICD10-CM/PCS coding performed by affiliate staff, inclusion of HIM Coding Supervisor and Quality Officer, for accuracy and completeness.
• Reviews HCPCS/CPT coding performed by affiliate staff, inclusion of HIM Coding Supervisor and Quality Officer, for accuracy and completeness.
• Reviews Discharge Status, Admission and Discharge Dates, and other related demographic information coded and entered by affiliate staff, inclusion of HIM Coding Supervisor and Quality Officer, for accuracy and completeness.
• Reviews Present on Admission (POA) indicators for all diagnosis coded and entered by affiliate staff, inclusion of HIM Coding Supervisor and Quality Officer, for accuracy and completeness.
• Reviews DRG and APC assignment performed by affiliate staff, inclusion of HIM Coding Supervisor and Quality Officer, for accuracy, dependent on payer and patient type.
• Reviews Physician Queries performed by affiliate staff, inclusion of HIM Coding Supervisor and Quality Officer, for necessity, and accuracy and completeness.
• Reviews Evaluation and Management (E/M) coding performed by affiliate staff, inclusion of employed physicians, for accuracy and completeness.
• Performs classroom training in ICD10-CM/PCS and CPT coding for affiliate staff at the Corporate Coding School.
• Performs periodic ICD10-CM/PCS, CPT, DRG, and APC training sessions for affiliate staff, including research and preparation of presentations and maintenance of attendance records.
• Performs mentoring for HIM Quality Officers.
• Reviews RAC recommendations for Medicare and Medicaid RACs and prepares appeal documents if applicable.
• Prepares detailed written reports of review activities.
• Maintains proper computer and written records of all review activity.
• Effectively communicates coding recommendations and reasoning for the recommendations.
• Performs regulatory coding research for HIM Coding Supervisors and Quality Officers.
• Assists internal and external Compliance counsel in external agency investigations, Corporate Integrity Agreement (CIA) and Independent Review Organization (IRO) reviews as required.
• May be required to assist in the formation of Corrective Action Plans for the affiliate staff.
• May be required to perform other related duties.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.