Clinical Coding Specialist - ProFee
- Requisition #: 171750
- Location: Houston, TX
- Posted Date: 12/18/2024
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
Analyzes medical records and abstracts clinical data by assigning codes from patient records in accordance to coding classification systems. Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures. Enters appropriate codes into the hospital's mainframe computer for the transfer of data to billing files for reimbursement. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous or unclear for coding purposes. Serves as a resource for other department users related to the abstracted coded data.
JOB-SPECIFIC COMPETENCIES/RESPONSIBILITIES:
PEOPLE/SERVICE - (34%)
· Queries physicians and/or departments when code assignments are not straightforward, or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
· Must be flexible and adapt to changing work assignments.
· Meet or exceed department production and accuracy standards.
· Response promptly to internal and external reviews for clarification, Business office requests, or reviews for accuracy
· Identify workflow issues and promptly inform management
CODING QUALITY/PROTECTED HEALTH INFORMATION - (40%)
· Possess a thorough knowledge and understanding of institutional coding policies and procedures; maintains knowledge of ICD-10-CM, HCPCS, and CPT-4 coding guidelines according to CMS, AMA, AHA, and other official sources.
· Analyzes medical records and abstract clinical data by assigning codes (ICD10, CPT, HCPCS) from patient records in accordance with coding classification systems.
· Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures.
· Exports appropriate codes from CodeRyte/CodeAssist and/or Epic charge systems.
· Assign appropriate modifiers and apply guidelines as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI).
· Resolves coding edits in Epic by performing a second review of medical record documentation and code assignments.
· Must exercise good judgment in making decisions in regard to coding and/or auditing outcomes.
DEVELOPMENT/INNOVATION - (26%)
· Advance professional growth and development of skills through continuing education, departmental coding rounds, and reviewing pertinent literature and educational forums.
· Participates and provides ongoing feedback, when necessary, on documentation challenges, potential coding compliance concerns, and opportunities for coding clinic updates.
· Participates in ongoing team and departmental staff meetings.
***Other duties assigned; descriptions above are not all-inclusive. The coding specialist will perform coding-related functions within the scope of responsibilities when requested.
Required Education:
Associate's degree in Health Information Management or Healthcare related.
Required Experience:
Two years of coding experience in a medical services environment or one year as a Clinical Coding Associate at M D Anderson Cancer Center . May substitute required education degree with additional years of equivalent experience on a one to one basis and no experience required with preferred degree.
Preferred Experience/Skills:
Knowledge and experience in Limited coverage determination (LCD) and National coverage determination (NCD), coding outpatient and inpatient professional services for Evaluation and Management -multispecialty with strong diagnosis coding experience, global rules for post-operative visits and knowledge of correct use of modifiers.
Other Requirements:
Must pass pre-employment skills test as required and administered by Human Resources.
License/Certification
One of the following Preferred:
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Additional Information
#LI-Remote
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
Analyzes medical records and abstracts clinical data by assigning codes from patient records in accordance to coding classification systems. Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures. Enters appropriate codes into the hospital's mainframe computer for the transfer of data to billing files for reimbursement. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous or unclear for coding purposes. Serves as a resource for other department users related to the abstracted coded data.
JOB-SPECIFIC COMPETENCIES/RESPONSIBILITIES:
PEOPLE/SERVICE - (34%)
· Queries physicians and/or departments when code assignments are not straightforward, or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
· Must be flexible and adapt to changing work assignments.
· Meet or exceed department production and accuracy standards.
· Response promptly to internal and external reviews for clarification, Business office requests, or reviews for accuracy
· Identify workflow issues and promptly inform management
CODING QUALITY/PROTECTED HEALTH INFORMATION - (40%)
· Possess a thorough knowledge and understanding of institutional coding policies and procedures; maintains knowledge of ICD-10-CM, HCPCS, and CPT-4 coding guidelines according to CMS, AMA, AHA, and other official sources.
· Analyzes medical records and abstract clinical data by assigning codes (ICD10, CPT, HCPCS) from patient records in accordance with coding classification systems.
· Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures.
· Exports appropriate codes from CodeRyte/CodeAssist and/or Epic charge systems.
· Assign appropriate modifiers and apply guidelines as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI).
· Resolves coding edits in Epic by performing a second review of medical record documentation and code assignments.
· Must exercise good judgment in making decisions in regard to coding and/or auditing outcomes.
DEVELOPMENT/INNOVATION - (26%)
· Advance professional growth and development of skills through continuing education, departmental coding rounds, and reviewing pertinent literature and educational forums.
· Participates and provides ongoing feedback, when necessary, on documentation challenges, potential coding compliance concerns, and opportunities for coding clinic updates.
· Participates in ongoing team and departmental staff meetings.
***Other duties assigned; descriptions above are not all-inclusive. The coding specialist will perform coding-related functions within the scope of responsibilities when requested.
Required Education:
Associate's degree in Health Information Management or Healthcare related.
Required Experience:
Two years of coding experience in a medical services environment or one year as a Clinical Coding Associate at M D Anderson Cancer Center . May substitute required education degree with additional years of equivalent experience on a one to one basis and no experience required with preferred degree.
Preferred Experience/Skills:
Knowledge and experience in Limited coverage determination (LCD) and National coverage determination (NCD), coding outpatient and inpatient professional services for Evaluation and Management -multispecialty with strong diagnosis coding experience, global rules for post-operative visits and knowledge of correct use of modifiers.
Other Requirements:
Must pass pre-employment skills test as required and administered by Human Resources.
License/Certification
One of the following Preferred:
- Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA).
- Registered Health Information Technician (RHIT) by the American Health Information Management Association (AHIMA).
- Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA).
- Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA).
- Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).
- Certified Professional Coder - Hospital (CPC-H) by the American Academy of Professional Coders (AAPC).
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Additional Information
- Requisition ID: 171750
- Employment Status: Full-Time
- Employee Status: Regular
- Work Week: Days
- Minimum Salary: US Dollar (USD) 55,500
- Midpoint Salary: US Dollar (USD) 69,500
- Maximum Salary : US Dollar (USD) 83,500
- FLSA: non-exempt and eligible for overtime pay
- Fund Type: Hard
- Work Location: Remote (within Texas only)
- Pivotal Position: Yes
- Referral Bonus Available?: No
- Relocation Assistance Available?: No
- Science Jobs: No
#LI-Remote
