Senior Clinical Coding Specialist - Surgery

MISSION STATEMENT

The mission of The University of Texas M.D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

SUMMARY:

The primary purpose of the Sr. Clinical Coding Specialist position is to analyze complex medical records and abstract clinical data by assigning codes from patient records in accordance with coding classification systems.

The following will apply to a position hired for the Interventional Radiology (IR) coder:

·       Matrix relationship to Revenue Operations & Coding, Supervisor and IR, Associate Director.

·       Split time and shared oversight with IR

·       CIRCC certification through the American Academy of Professional coders

·       Training and quality oversight of the IR technologist

·       Routine quality review reports   

 KEY FUNCTIONS:

1.     Analyzes complex medical records to abstract clinical data by assigning codes from patient records in accordance with the coding classification systems of ICD-10-CM and/or CPT. 

2.     Reviews patient encounters for accurate code assignment(s) of all relevant diagnosis, procedures and/or modifiers.    

3.     Applies guidelines as indicated through the Local Coverage Determination (LCD), National Coverage Determination (NCD), as well as the National Correct Coding Initiative (CCI).

4.     Coder meets and maintains a production rate of 90% or higher.

5.     Coder meets and maintains an accuracy rate of 90% on all coded records.

6.     Queries physicians and/or departments when code assignments are not straightforward or if documentation in the record is inadequate, ambiguous or unclear for coding purposes.  

7.     Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, seminars, and other educational forums.  

8.     Identifies and reports documentation issues and may participate in team or provider educational activities.  

9.     Communicates effectively and demonstrates good interpersonal and professional skills when interacting with others.

10.  May be required to attend/participate in group, or individual meetings with providers of service, or with administration.

11.  May collect and prepare data for management review. 

12.  Serves as a resource concerning clinical coding practice, policies and procedures. 

13.  Report problems/concerns to management proactively for continuous process improvement.

14.  Review and provide resolution of edits/warnings.

15.  Resolves claim and billing edits as well as denials by performing second review of medical record documentation and code assignments.

16.  Other duties, as assigned.

 WORK CONDITIONS:

This position requires:

            Working in Office Environment                    ____ No            __X__ Yes

            Working in Patient Care Unit (e.g. nursing

            Unit; outpatient clinic)                                   _X__ No            ______ Yes

            Exposure to human/animal blood,

            Body fluids, or tissues                                    __X__ No            ____ Yes

            Exposure to harmful chemicals                      __ X__ No            ____ Yes

            Exposure to radiation                                     __ X__ No            ____ Yes

            Exposure to animal’s                                      __ X__ No            ____ Yes

  PHYSICAL DEMANDS

Indicate the time required to do each of the following physical demands: