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Coding Edits Specialist
Remote
The coding edits specialist will be responsible to correct coding edits to include CCI, MUE, and Medical Necessity Edits on accounts of all patient types in addition to periodic coding. Will ensure that all coding assignments are accurate according to coding policies and based on the documentation provided in the medical record. Using a thorough knowledge of coding policies and procedures as well as medical terminology and technology,. Ensure compliance with official guidelines (ICD-10-CM, AHA Coding Clinic, AMA CPT Assistant and Guidelines), AHIMA Standards of Ethical Coding, and LifePoint Health Support Center (HSC) policies and procedures.
ESSENTIAL FUNCTIONS:
- Review coding edits to determine if coding corrections are appropriate
- Assign appropriate diagnosis and procedure codes utilizing ICD 10-CM, CPT, and HCPCS according to the Centers for Medicare & Medicaid Services (CMS) requirements for hospital billing.
- Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
- Must be familiar with Ambulatory Payment Categories (APCs, the Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) guidelines, Local and National Coverage Decisions, and other medical necessity/compliance guidelines for billing and coding.
- Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the coding area.
- Follow coding workflows for service type to include addressing compliance reviews.
- Submit physician queries when clarification of documentation is needed.
- Assist others with responsibilities and adjusts work schedule to meet department needs.
- Use independent discretion/decision-making while effectively working remotely.
- Attend required educational webinars, conference calls, and other coding seminars, and participate in all formal and informal coding discussions.
- Maintain coding education hours and renew annual coding credentials as applicable.
- Complete all assigned compliance courses within the designated period.
- Conform to AHIMA’s Code of Ethics and Standards of Ethical Coding, Attendance Policy, and ensure patient/employee privacy and dignity by maintaining confidentiality with no infractions.
- Other related job tasks or responsibilities as assigned.
Additional Information:
The position serves internal co-workers and external customers, clients, and contractors.
Access to and/or work with sensitive and/or confidential information.
KNOWLEDGE, SKILLS & ABILITIES:
The requirements below represent the required knowledge, skills, and/or abilities.
Education: Associate degree in health-related field preferred.
Experience: Two years of coding edit experience preferred.
Certifications: Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) preferred.
Licenses: N/A
Skills and Abilities:
- Candidate must possess excellent organizational skills and communication skills.
- Candidate must be adept in utilizing computer programs and the Internet.
Candidate must be self-motivated and possess the ability to work independently.
Location: remote,
Type: Contract
Pay: Apply for details
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