Single Path Coding Specialist II

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This position is responsible for the accurate assignment of procedures and diagnostic codes to patient records using different forms of coding classification systems. This includes abstracting data for appropriate reimbursement, compliance, and charging with the national, regional, and local guidelines and policies. Applies clinical knowledge of disease processes, physiology, pharmacology and surgical techniques by reviewing and interpreting all clinical documentation. In most cases, responsible for the coding of moderately complex patient classes i.e. ED, same day care, clinic visits, etc. Periodically perform tasks in the areas of claim edits and/or denials.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High School Diploma or Equivalent.                                                                                                          

2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), CCS (Certified Coding Specialist), COC-A (Certified Outpatient Coder-Apprentice), COC (Certified Outpatient Coder), CPC (Certified Professional Coder), Formerly CPC-H (Certified Professional Coder-Hospital), CIC (Certified Inpatient Coder), or

CCS-P (Certified Coding Specialist - Physician Based).  

EXPERIENCE:
1. Two years of medical coding required

PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program. 

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Reviews and accurately interprets medical record documentation  and assign all diagnosis and/or procedures using the appropriate ICD-10, CPT, DRG or modifier codes. 

2. Responsible for hospital based and/or provider based coding on on moderately complex services, i.e. ED, same day care, clinic visits, etc. 

3. Responsible for hospital based coding of low complex inpatient services.

4. Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation.

5. Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.).

6. Maintains the coding productivity standard

7. Maintains the coding quality standard

8.Participates in quality reviews, in-services, seminars, meetings, reviewing reference material and other educational opportunities as directed.

9. Works and communicates with other offices in any manner necessary to facilitate the coding process. 

10. Reports trends or concerns of documentation and charges to management.

11. Proficient in coding-related technology around day-to-day functions i.e. (3M, MS Office, Teams, Etc.)
12. Communicate professionally and appropriately when using any communication channels.
13. Other duties as assigned

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.  Must be able to sit for long periods of time.
2.  Must have visual and hearing acuity within the normal range. 
3.  Must have manual dexterity needed to operate computer and office equipment.​

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.  Standard remote office environment (Telecommute)
2.  Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.
3.  May require travel.

SKILLS AND ABILITIES:

1. Must be able to concentrate and maintain accuracy during constant interruptions.
2. Must possess independent decision-making ability.
3. Must possess the ability to prioritize job duties.
4. Must be able to handle high-stress situations.                                                              

5. Must be able to adapt to changes in the workplace.
6. Must be able to organize and complete assigned tasks.
7. Must possess excellent written and verbal communication skills.
8. Must meet quality and productivity standards.
9. Must possess knowledge of anatomy, physiology, and medical terminology.
10. Must possess technical skills and knowledge using Microsoft office, excel, and word.
11. Proficiency in coding technology software and related workflow.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Day (United States of America)

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

548 SYSTEM HIM Coding Analysis