documentation to assign accurate ICD-10, CPT, HCPCS codes, and modifiers for
complex procedures performed throughout WVU Medicine. Complies with
national coding guidelines to ensure that all procedures are coded accurately
and consistently. Applies coding conventions and rules established by the
American Medical Association (AMA) and the Centers for Medicare and Medicaid
Services (CMS) when assigning procedural, diagnostic, and HCPCS codes to
ensure that they are in accordance with CCI edits, MUE edits, LCD, and
NCDs. Contacts & Collaborates with appropriate personnel for
documentation insufficiencies and to expedite resolution of accounts.
MINIMUM QUALIFICATIONS:
EDUCATION,
CERTIFICATION, AND/OR LICENSURE:
1.
High School Diploma or Equivalent.
2.
Associates
degree in Health Information Management with RHIT (Registered Health
Information Technician) or RHIA (Registered Health Information Administrator)
OR CCS (Certified Coding Specialist) or CCS-P (Certified Coding
Specialist Physician Based) or CPC (Certified Professional Coder).
EXPERIENCE:
1.
Two
years of medical coding experience required.
2.
One
year of advanced surgical coding experience required.
3.
Obtain
Specialty Medical Coding Certification within one year of hire.
PREFERRED QUALIFICATIONS:
EXPERIENCE:
1.
Four
(4) years of coding experience strongly preferred.
CORE
DUTIES AND RESPONSIBILITIES: The
statements described here are intended to describe the general nature of work
being performed by people assigned to this position. They are not intended
to be constructed as an all-inclusive list of all responsibilities and
duties. Other duties may be assigned.
1.
Accurately codes and/or audits complex surgical
procedures as part of daily workload (85%-95% of workload) including but not
limited to: Bariatric surgery, Cardiothoracic surgery, Gynecologic surgery,
Oncology surgery, Orthopaedics surgery, Thoracic surgery, Transplant surgery,
Trauma and burn surgery, and Open Vascular surgery.
2.
Reviews and accurately interprets
medical record documentation from all accounts in order to identify all
diagnosis and procedures that affect the current inpatient stay or outpatient
encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each
diagnosis and procedure that is identified.
3.
Assures that quality and timely
coding, charging and abstraction of accounts are completed daily for assigned
specialty areas.
4.
Maintains and enhances current levels of coding
knowledge through quality review, attendance and participation at clinical
in-services and coding seminars, internal meetings, study of circulating
reference materials, and inclusion of updates to coding manuals.
5.
Assures the accuracy, quality, and timely review of
data needed to obtain a clean bill.
6.
Contacts physicians or any persons
necessary to obtain information required to accurately code assignments.
Works and communicates with other offices in any manner necessary to
facilitate the billing process.
7.
Monitors on an on-going basis provider
documentation. Performs audits to assess provider coding accuracy and follows
up with provider education as needed.
8.
Provides assistance to Revenue Cycle
Operations in claim development functions to resolve problem patient
accounts.
9.
Analyzes and
resolves issues of missing charges and problem accounts by researching
information regarding department reimbursement.
10.
Interacts with physician and
non-physician providers to maximize correct coding initiatives.
11.
Maintains a level of expertise and
ever expanding knowledge in coding and sequencing guidelines to ensure that
all healthcare information is accurately assigned and appropriate.
PHYSICAL
REQUIREMENTS: The
physical demands described here are representative of those that must be met
by an employee to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities
to perform the essential functions.
1.
Must be able to sit for long periods
of time.
2.
Must have visual and hearing acuity within
the normal range.
3.
Must have manual dexterity needed to
operate computer and office equipment.
4.
Must be Able to lift, push or pull 10-20
pounds.
WORKING
ENVIRONMENT: The work
environment characteristics described here are representative of those an
employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities
to perform the essential functions.
1.
Standard office environment.
2.
Visual strain may be encountered in
viewing computer screens, spreadsheets, and other written material.
3.
May require travel.
SKILLS
AND ABILITIES:
1.
Must be able to concentrate and
maintain accuracy during constant interruptions.
2.
Must possess independent decision-making
ability.
3.
Must
possess the ability to prioritize job duties.
4.
Must
be able to handle high stress situations.
5.
Must
be able to adapt to changes in the workplace.
6.
Must
be able to organize and complete assigned tasks.
7.
Must
possess excellent written and verbal communication skills.
8.
Must
meet quality and productivity standards.
9.
Must
possess the knowledge of anatomy, physiology and medical terminology.
Date
Reviewed/Revised: August 2018