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Clinical Coding Specialist - ProFee
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Analyzes medical records and abstract clinical data by assigning codes (ICD10, CPT, HCPCS) from patient records in accordance with coding classification systems.
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Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures. Exports appropriate codes from CodeRyte and/or Epic charge systems.
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Assign appropriate modifiers, and apply guidelines as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI).
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Meet or exceed department production and accuracy standards.
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Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, AAPC/AHIMA seminars, and other educational forums.
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Queries physicians and/or departments when code assignments are not straightforward or documentation in the record is inadequate, ambiguous or unclear for coding purposes.
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Resolves coding edits in Epic by performing second review of medical record documentation and code assignments.
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Must be flexible and adapt to changing work assignments.
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Must exercise good judgment in making decisions in regard to coding and/or auditing outcomes.
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Possess a thorough knowledge and understanding of institutional coding policies and procedures; maintains knowledge of ICD-10-CM, HCPCS and CPT-4 coding guidelines according to CMS, AMA, AHA and other official sources.
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Other duties as assigned
Knowledge and experience in Limited coverage determination (LCD) and National coverage determination (NCD), coding outpatient and inpatient professional services for Evaluation and Management -multispecialty with strong diagnosis coding experience, global rules for post-operative visits and knowledge of correct use of modifiers.
License/Certification
One of the following Preferred:
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Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA).
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Registered Health Information Technician (RHIT) by the American Health Information Management Association (AHIMA).
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Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA).
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Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA).
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Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).
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Certified Professional Coder - Hospital (CPC-H) by the American Academy of Professional Coders (AAPC).
