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We’re searching for a Coding Quality Assurance Specialist I - someone who works well in a fast-paced setting. In this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. The position also ascertains the accuracy of the physicians' E/M and procedure coding, completes the auditing reporting tool, and provides this feedback to the education team and/or provider.
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Job Duties & Responsibilities
Assigns ICD-10-CM and CPT codes.
Reviews documentation in records to appropriately assign ICD-10-CM, PCS, and CPT codes.
Communicates with and provides feedback to the education team and/or provider.
Utilizes the encoder or coding books to correctly assign all appropriate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
Sequences diagnosis and procedures to generate appropriate DRGs for billing in accordance with the Coding Guidelines based on the type of coding.
Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
Utilizes available resources for assignment of codes as necessary (e.g., Diagnostic Imaging system, Lab system, Emergency Center system, Cardiac Cath system, Epic, and coding reference books).
Inputs codes into the Epic computer system utilizing the Encoder.
Completes abstracts if appropriate.
Identifies problem accounts.
Assists in correction of problem accounts.
Participates in education and maintains certification.
Maintains concurrent coding for all records.
Skills & Requirements
Required H.S. Diploma or GED
Required Certifications
LCCA - Certified Coding Associate
CCS - Cert-Cert Coding Specialist
CCS-P - Cert-CCS-P Physician Based
CIPC - Certified Inpatient Coder
COC - Certified Outpatient Coder
COC-A - Cert Outpat Coder - Apprentice
CPC - Cert-Cert Professional Coder
CPC-A - Cert Prof Coder - Apprentice
CRC - Cert Risk Adjustment Coder
RHIA - Cert-Reg Health Infm. Admins
RHIT - Cert-Reg Health Infm. TECH
Required 1 years’ experience as a coder
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