Coding Compliance Specialist jobs in Raleigh, NC

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children's Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

Reviews medical record documentation, extracts data, and applies appropriate diagnosis and procedure codes for complex outpatient hospital, ambulatory surgery, intermediate level of inpatient accounts and behavior health to support hospital billing, internal and external reporting, research and regulatory compliance. Complies with the ICD-9-CM Official Guidelines for Coding and Reporting as well as other nationally established rules and regulations for coding assignment.

Responsibilities

Provide code assignment for the following complex inpatient accounts: cardiac, complex cancer, complicated OB, NICU, PICU, complicated orthopedic, tracheostomy, trauma and vascular.

Assigning diagnostic and procedural codes to patient records using ICD-10-CM and any other designated coding classification system in accordance with the UHDDS coding guidelines.

Assigning and sequencing codes accurately based on medical record documentation.

Assigns diagnosis/procedure codes utilizing the 3M Encoder and CAC to arrive at the most accurate code within 5 days of date of service.

Incorporates current regulatory coding requirements and guidelines appropriately.

Maintains weekly coding productivity log and provides feedback to the Manager of HIMS regarding any coding issues/problems.

Maintains coding accuracy of 95% or better.

Average number of records coded per week must meet minimum established quantitative standards per type of patient record.

Responsible for reviewing claims and correcting edits through CAC/Audit Expert.

Demonstrates effective computer skills for all coding functions.

Maintains confidentiality of patient information.

Participates in In-Service education, updates and conferences to remain current with coding requirements and guidelines.

Demonstrates competency in the MSDRG system and be able to differentiate between inpatient and outpatient guidelines.

Demonstrates competency and retrospectively codes all Intermediate inpatient accounts, indicating the POA indicator correctly, discharge disposition and ensuring correct DRG assignment following all hospital regulatory guidelines.

Must have knowledge of the Clinical Documentation Management Program and assist the Documentation Specialist with questions regarding code/DRG assignment.

Serves as back up for the Coding Specialist I and Coding Specialist II when needed.
Maintains AHIMA credentials.

Minimum Requirements

High School or equivalent (GED) and one of the following AHIMA credentials is required: RHIA, RHIT, CCS

Associate's Degree in Health Information Technology or Bachelor's Degree in Health Information Management is preferred.

3 years coding complex level inpatient charts at an Academic Medical Center is required.

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant's qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.