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The Coding Specialist III position assigns diagnosis and procedure codes using the appropriate coding classification system to reflect the care and services rendered to the patients in the inpatient, emergency department, ancillary, and outpatient surgery settings. Ensure the accurate selection of the principal diagnosis and principal procedure, as well as, all other significant diagnoses and procedures. Abstract hospital– defined data from records for data collection purposes. Ensure compliance with official guidelines (ICD– 10– CM, ICD– 10– PCS, AMA CPT Assistant and Guidelines, and/or AHA Coding Clinic), AHIMA Standards of Ethical Coding and Hiring Company Support Center (HSC) policies and procedures.
- Inpatient coders will assign ICD– 10– CM and ICD– 10– PCS codes correctly with a coding error rate of less than 5% in accordance with established guidelines for reimbursement and statistical data.
- Outpatient coders will assign ICD– 10– CM, CPT and HCPCS codes correctly with a coding error rate of less than 5% in accordance with established guidelines for reimbursement and statistical data.
- Maintain quarterly minimum 95% coding accuracy and monthly productivity standards of 95% consistently.
- Prioritizes coding functions to assure records are coded within facility defined number of days from discharge. Collaborates with the team to maintain and exceed DNFC goals while maintaining good employee relations.
- Attends educational webinars, conference calls, other coding seminars, and participates in all formal and informal coding discussions. Complete all assigned compliance courses within assigned period of time.
- Maintains at least twenty (20) continuing education hours annually and maintain required credentials.
- Conforms to AHIMA’s Code of Ethics and Standards of Ethical Coding and ensures patient/employee privacy by maintaining confidentiality.
- Inpatient coders must be familiar with Diagnosis Related Groups (DRGs), the Inpatient Prospective Payment System (IPPS), and other medical necessity/compliance guidelines for billing and coding.
- Outpatient coders must be familiar with Ambulatory Payment Groups (APGs), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative guidelines, Local and National Coverage Decisions, and other medical necessity/compliance guidelines for billing and coding.
- Regular and reliable attendance.
- Perform other duties as assigned.
- Position serves both internal co– workers and external clients, customers, contractors, and vendors.
- Access to and/or works with sensitive and/or confidential information.
Not responsible for supervising employees.
KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.
Education: High School Diploma or GED equivalent
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