Incumbent must have skill set to:
- Address appeals and review needed information for insurance denials to facilitate expedient resolution and reimbursement.
- Participates in mandated Medical Record Review processes.
- Interprets and applies American Hospital Association (AHA) Official Coding Guidelines to articulate and support appropriate principal, secondary diagnoses and procedures.
- Knowledge of discharge disposition and reimbursement outcomes.
- Adherence to Health Information Management (HIM) Coding policies.
- Adherence to The Joint Commission (TJC) and other third-party documentation guidelines in an effort to continually improve coding quality and accuracy.
- Responsibility for maintaining coding certification and continuing education.
- Participates in performance improvement initiatives as assigned.
KNOWLEDGE, SKILLS & ABILITIES
- Expert knowledge and specific details of coding conventions and use of coding nomenclature consistent with CMS’ Official Guidelines for Coding and Reporting ICD-10-CM coding.
- Expert knowledge of Anatomy and Physiology of the human body, Pharmacology, Disease Pathology, and Medical Terminology in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures performed.
- Accurate translation of written diagnostic descriptions to appropriately and accurately assign ICD-10-CM diagnostic codes and procedural codes to obtain optimal reimbursement from all payer types, including Medicare/Medicaid, private and commercial insurance payers.
- Knowledge of clinical content standards.
- Ability and knowledge of the appeal process to ensure accurate reimbursement.
- Utilize critical thinking and problem-solving abilities.
- Ability to work well with others.
- Uphold a strong work ethic characterized by honesty and dependability.
- Demonstrate personal time management skills, including organization, prioritization, and multitasking.
- Adherence to company policies, procedures, and directives.
This position does not provide patient care.
Licenses: None
Required Certifications: CCS, CCS-P, CPC, COC and/or CIC Coding credential required. (Excludes apprenticeship classification)
Experience Required: A minimum of 5-8 years of previous facility and/or pro-fee coding experience required. A minimum of 2 years of previous experience performing, analyzing, and providing feedback on physician documentation and coding audits required. Teaching experience for a variety of comprehension levels preferred.
Computer/Typing: Must be proficient with Microsoft Office Suite, including Outlook, Power Point, Excel, and Word. Must have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Shift: M-F 8a-5p PST; weekends and Overtime are options
Weekly Guaranteed Hours: 40
Weekend Hours:, OT and weekends are usually optional but can be mandatory depending on business needs.( All Positions are Hourly)
Pay Range: 67k - 85k, yearly salary
**In addition to the benefits, new employees can receive from Renown, we also pay for our staff’s annual membership fees with their accrediting organization and we pay for continue education hours so that our staff can maintain their certifications.
Additional Comments:
Cannot hire in following states: CA, NY, CO, NJ, IL, HI, and Seattle WA