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CODING SPECIALIST - OUTPATIENT in Prince Frederick, Maryland at CalvertHealth

CalvertHealth
Prince Frederick, Maryland, 20678, United States
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Job Description

  • JOB DESCRIPTION DETAILS
    • Reports to:
      • HIM Coding Manager
    • Job Summary:
      • Codes and abstracts outpatient medical records in accordance with established coding conventions and guidelines.
    • Education:
      • Associate's or Bachelor's degree in Health Information Management (HIM) or Coding, preferred. Position requires formal working knowledge equivalent to a two or four year degree in HIM or Coding.
    • Registration/Certification/Licensure:
      • AHIMA Certifications (RHIA, RHIT, CCS, CCS-P)
      • AAPC Certifications (CPC, CPC-H)
    • Experience:
      • 1+ years outpatient facility coding or related experience.
      • Possess a strong grasp of: Ambulatory Payment Classifications (APC's), all Patient Refined Diagnosis Related Groups (APR-DRGs) - Maryland, andPotentially Preventable Complications (PPCs)/Maryland Hospital Acquired Conditions (MHACS) experience, required.
      • Familiarity with Meditech and 3M Coding and Reimbursement System, preferred.
      • 360 Encompass experience, a plus.
    • Other Requirements:
      • Maintains unit-specific and hospital competencies, mandatory learning, and any clinical certifications required in accordance with the Staff Education and Training policy GA-057 and/or any other department requirements.
      • Comprehensive knowledge of Pathophysiology, disease processes, Pharmacology and Medical Terminology.
      • Ability to effectively communicate with clinical and non-clinical staff, both verbally and in writing.
      • Knowledge of HIM workflow.
      • Ability to complete and submit physician queries as appropriate.
      • Effectively communicates with clinical and non-clinical staff, both verbally and in writing, by implementing organization-wide communication techniques as a daily practice.
      • Demonstrated proficiency of computer skills necessary to effectively complete position requirements.
      • Ability to work independently and prioritize tasks producing quality work that is timely.
    • FLSA Status:
      • Non-Exempt
    • Populations Served/Patient Care Responsibilities
      • All age populations
  • TECHNICAL COMPETENCIES
    • Principle Duties and Responsibilities:
      • Reviews clinical documentation and diagnostic results to accurately extract data and assign appropriate ICD-10-CM/CPT codes for billing internal and external reporting, research and regulatory compliance.
      • Accurately assigns codes utilizing ICD-10-CM and CPT codes for inpatient and outpatient records as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.
      • Assigns principal and secondary diagnosis and procedure codes using the computer system and encoder.
      • Works with the Clinical Documentation Analyst to assist in the development and improvement in the Clinical Documentation Improvement program (inpatient).
      • Contacts physicians when recognizing when further documentation clarification is needed for accurate coding and appropriately queries the physician.
      • Abstracts required data elements as instructed.
      • Establishes and maintains an outpatient coding accuracy rate of 95% or greater.
      • Establishes and maintains an outpatient coding production rate of 90% or greater.
      • Ensures HIPAA compliance at all times.
      • Abides by the standards of Ethical Coding set forth by the American Health Information Management Association (AHIMA).
      • Attends coding specific hospital meetings with the Director of HIM and/or the Coding Manager.

Job Location

Prince Frederick, Maryland, 20678, United States

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