Coding Compliance Specialist jobs in Kansas City, MO

Position Summary

The HIM Technician will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance).

Under the direction of the Health Information Management (HIM) the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.

Essential Functions and Responsibilities

Assigns codes for diagnoses, treatments and procedures according to the appropriate classification system for outpatient encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.

Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.

Able to accurately abstract information from the medial records into the abstract system, according to established guidelines.

Enters and validates codes, charges (including surgery and anesthesia) and other edits flagged.

Review documentation (and returned accounts) to verify data elements (ie: NDC #, or number of units, etc…)

Uses CCI edit software to check modifier appropriateness and LCD’s/NCD’s for medical necessity.

Communication with other departments (via phone calls, email, or face to face) to recommend coding guidance for charge corrections and patient billing concerns.

Meet and/or exceeds the established coding productivity standards.

Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards.

Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.

Carroll County Memorial Hospital is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

Education/Experience

High School Diploma or GED required

RHIT, CCS, CPC, CCA preferred

Minimum of 3 years hospital outpatient coding experience preferred

Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (ie: Documentation Guidelines ’95 & ’97)

Knowledge of government, and commercial payer guidelines.

Must be able to use standard office equipment and information systems.

Ability to interact with other employees through effective communication.

Ability to prioritize to ensure departmental goals align with revenue cycle goals