*Work schedule Mon – Fri 8am – 4:30 pm.
*Remote – work from home / monthly onsite required meetings in Woodlands office unless out of region
Must have experience with risk adjustment coding.
Business Title: Medical Coding Specialist
Position Summary (Purpose of job):
Abstracts clinical information from a variety of medical records and assigns appropriate ICD 9 CM and/or CPT codes to patient records according to established procedures. Analyzes, enters and manipulates database, confirms appropriate DRG assignments. Knowledge in ICD-9 and CPT-4 coding required. CAREER LEVEL DESCRIPTION: Experienced, fully competent in own area covering a wide range of tasks. Completes own role independently or with minimal supervision. KNOWLEDGE: Complete understanding of the general and technical aspects of the job. PROBLEM COMPLEXITY: Provides resolutions to a wide range of problems. Job requires judgement within defined policies and practices. MINIMUM EDUCATION & TYPICAL EXPERIENCE OR EQUIV. COMBINATION: Works with limited autonomy and under moderate direction. Routine work requires no direction. Work is evaluated upon completion to ensure objectives have been met.
Key Responsibilities (List the top five to seven essential responsibilities in priority order.)
Abstracts relevant clinical and demographic information from the medical record to assign current ICD-10 and CPT codes in accordance with coding and reimbursement guidelines.
-Identifies eligible HCCs (Hierarchal Condition Coding) when appropriate in relation to -provided guidelines, with minimal error, based on provider documentation
-Follows coding processes and procedures along with updating them as directed by manager.
- Performs the minimum number of validations consistent with established departmental goals .
- Provides clear communication, with the ability to Identify and report quality concerns and errors. Able to query providers when appropriate
--Requests documentation / diagnosis from provider when information is not recorded.
-Determines and records the required medical information and additions to the Problem List in the EHR in accordance to established guidelines
-. Works with appropriate clinic staff in coordinating medical information for completion of patient record with HCCs.
- Updates coding procedures and guidelines in coordination with Coding Manager
-Maintains the confidentiality of the medical information contained in each record.
-Patient information to be handled in accordance with HIPAA guidelines
-Expected to be able to partner with practices and peers in a collaborative way in coordination with manager and director.
Participates virtually in team and department meetings, educational sessions and events.
Maintains patient privacy according to local and national laws, treating all patient and family information as privileged and protected.
Follows McKesson ICARE and ILEAD policies
Follows and abides by remote employee guidelines.
Minimum Education:
-High School graduate or equivalent
-3-5 years of outpatient coding experience
-minimum of 2 years of HCC coding
-excellent knowledge of ICD-10 and CPT Coding Systems required
-Must be well versed in handling PHI.
-CPC, CRC, COC or CCA certification from the American Academy of Professional Coders or AHIMA
Minimum Job Qualifications (Knowledge, Skills, & Abilities):
Education/Training – Certified Coder
Minimum of 90% accuracy required
Minimum of 50 charts per day reviewed for HCCs
Oncology experience preferred
Must be able to work remote and have dedicated space for workstation and highspeed internet in place
Must be able to be ON CAMERA during the day for all meetings
-Will be required to come on site for Monthly meeting and special training when needed inspections
-must be able to join all training, meetings and conversations with coworkers and management online with laptop camera and audio on.
Specialized Knowledge/Skills –
-Excel experience
-Excellent communication and listening skills
-Critical thinker
-Problem solve
-Self motivated
-Flexible and quickly adapts to change
-Organization and Time Management
Working Conditions:
*Remote – work from home / monthly onsite required meetings in Woodlands office unless out of region
*Work schedule Mon – Fri 8am – 4:30 pm.
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