HIM Coding Editor Specialist I
New
P
ParklandHealthcare coding
Remote positions at Parkland for this team can only hire from candidates who live in these states: Arkansas, Wisconsin, Texas, Florida (cannot hire Miami-Dade county).Full-TimeSenior
Salary not disclosed
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Job Details
- Experience
- Must have five years of coding experience in an acute care hospital environment.
- Required Skills
- MS Office
Requirements
- Have five years of coding experience in an acute care hospital environment.
- Have successfully completed an approved coding program or graduated from a Health Information Management program; equivalent education and experience may be considered.
- Hold one of the listed AHIMA certifications: RHIT, RHIA, CCS, or CCS-P.
- Alternatively, hold one of the listed AAPC certifications: CPC-H or CPC.
- Demonstrate advanced coding and abstracting skills.
- Pass the applicable coding test with a score of 85% or above.
- Demonstrate knowledge of Medicare and Medicaid reimbursement principles.
- Have extensive knowledge of medical terminology, the human disease process, anatomy, and physiology.
- Demonstrate organizational and leadership skills and the ability to communicate orally and in writing.
- Demonstrate knowledge of computer software applications, including MS Office.
Responsibilities
- Verify CPT code accuracy for complex or error-prone procedures and diagnosis coding accuracy for complex or error-prone encounters.
- Review charge and procedure mismatches, revenue integrity edits for NCD/LCD coverage, invalid codes, code conflicts, and missing modifiers.
- Resolve billing edits and HIM/Coding unbilled holds by reviewing claims, medical records, and other applicable documentation.
- Assign diagnosis and procedure codes for inpatient and outpatient episodes of care using applicable coding conventions and guidelines.
- Review APC/MS-DRG options and determine secondary diagnoses that meet reporting criteria.
- Communicate with physicians and nurses to clarify documentation and resolve missing or ambiguous coding information.
- Coordinate with billing, revenue integrity, coding operations, coding compliance, and other revenue cycle teams.
- Identify potential quality issues, analyze root causes, and recommend improvements to coding and billing processes.
- Maintain departmental quality standards and ensure unbilled items are addressed timely.
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