A Brief Overview

Responsible for accurately and timely coding of moderately complex encounters following established coding, CMS regulations and hospital guidelines. Accurately codes diagnostic and procedural information following official coding guidelines, facility specific guidelines and federal regulations.

What You Will Do

• Reviews moderately complex medical records to identify sequence, code diagnoses and procedures according to established coding, CMS and hospital guidelines.
• Responsible for accurately coding hospital same day surgery, observations, ancillary, ED encounters and/or professional services.
• Ensures optimal CPT, ASC, APC, APG assignment as applicable.
• Understanding and ability to resolve coding specific edits such as CCI, LCD, NCD, and MUE.
• Supports OP Clinical Documentation Improvement program.
• Maintains productivity and quality rate according to established standards.
• Works within UH Billing time frames.
• Maintains coding knowledge and skills via written coding resources, clinical information and educational webinars. Maintains knowledge of guidelines and regulations affecting the UHHS Coding Department. Maintains up to date credentials.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).

Additional Responsibilities

• Participates in educational and informational activities as required.
• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Education

• High School Equivalent / GED (Required)
• Associate's Degree preferably in HIM (Preferred) or
• Bachelor's Degree (Preferred)

Work Experience

• 2+ years ICD-10 CM, PCS and/or CPT coding experience (Required)

Knowledge, Skills, & Abilities

• Medical terminology, anatomy/physiology, pathophysiology and pharmacology knowledge (Required proficiency)
• Detail-oriented and organized, with good analytic and problem solving ability. (Required proficiency)
• Self-motivated with ability to function independently and as a team player in a fast-paced environment. (Required proficiency)
• Strong written and verbal communication skills. (Required proficiency)
• Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, FAX machine, etc.). Must be able to proficiently work within with multiple systems. (Required proficiency)

Licenses and Certifications

• Certified Professional Coder (CPC) (Required Upon Hire) or
• Certified Coding Specialist (CCS) (Required Upon Hire) or
• Registered Health Information Technologist (RHIT) (Required Upon Hire) or
• Registered Health Information Administration (RHIA) (Required Upon Hire) or
• Certified Coding Associate (CCA) (Required Upon Hire) or
• Radiology Coding Certification (RCC) (Required Upon Hire) or
• Radiation Oncology Certified Coder (ROCC) (Required Upon Hire) or
• Certified Hematology and Oncology Coder (CHONC) (Required Upon Hire)

Physical Demands

• Standing Occasionally
• Walking Occasionally
• Sitting Constantly
• Lifting Rarely up to 20 lbs
• Carrying Rarely up to 20 lbs
• Pushing Rarely up to 20 lbs
• Pulling Rarely up to 20 lbs
• Climbing Rarely up to 20 lbs
• Balancing Rarely
• Stooping Rarely
• Kneeling Rarely
• Crouching Rarely
• Crawling Rarely
• Reaching Rarely
• Handling Occasionally
• Grasping Occasionally
• Feeling Rarely
• Talking Constantly
• Hearing Constantly
• Repetitive Motions Frequently
• Eye/Hand/Foot Coordination Frequently

Travel Requirements

• 10%25