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Become A Medical Coding Specialist

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Working As A Medical Coding Specialist

  • Getting Information
  • Processing Information
  • Documenting/Recording Information
  • Interacting With Computers
  • Organizing, Planning, and Prioritizing Work
  • Mostly Sitting

  • Repetitive

  • $37,110

    Average Salary

What Does A Medical Coding Specialist Do At Valley View Medical Center

* Review outpatient records and interpret documentation to identify all diagnoses and procedures; applying knowledge of medical terminology, disease processes, and pharmacology.
* Assigns proper ICD
* CM/ICD-10-CM and CPT diagnosis and procedure codes in accordance with Official Coding Guidelines.
* Code outpatient surgery/invasive procedure charts consistently according to the national gold standard utilizing the 3M CRS grouper for proper APC assignments, correct modifier usage, etc.
* Contact the physician and/or staff when necessary to gain additional information or clarify documentation discrepancies.
* Maintain the Outpatient Discharged Not Final Billed (DNFB) report on a regular basis; ensure accounts do not remain un-finalized past payer specific billing guidelines.
* Assess the adequacy of medical record documentation to ensure it supports all reportable diagnoses and procedures.
* Communicate daily to appropriate persons regarding any issues or concerns pertaining to coding, abstracting, or billing.
* Notify the appropriate manager if a medical chart is not available within forty-eight hours of discharge.
* Assist in the development, review, and assessment of departmental goals and objectives.
* Maintain an up-to-date knowledge and understanding of current trends and widely accepted practices related to Health Information Management; pursue professional growth and development opportunities.
* Other duties as assigned

What Does A Medical Coding Specialist Do At Phoenix Healthcare Services

* Coordinates with staff to get charge information for all patients in an EHR environment.
* Codes information about procedures performed and diagnosis on charge.
* Verifies and completes charge information in database and produces billing.
* Gathers and verifies all information required to produce a clean claim, including special billing procedures that may be defined by a payer or contract.
* Follows ICD9/ICD10 codes to ensure diagnosis codes are appropriate.
* Assists in charge capture by reviewing provider documentation and patient documentation.
* Queries provider when code assignments are not straightforward, or documentation is unclear.
* Keeps supervisor apprised of matters regarding charge entry.
* Works in conjunction with A/R team on follow up and resolution of coding related denials and rejections.
* Responsible for maintaining current knowledge of coding guidelines through the use of current CPT, HCPCS II and ICD
* materials.
* Responsible for maintaining current documentation guidelines and communicating those to providers.
* Maintains a high level of customer service.
* Maintains current knowledge of industry standards and regulations.
* Conducts all job functions in compliance with HIPAA and industry regulations

What Does A Medical Coding Specialist Do At Mercyhealth

* Reviews, analyzes, and interprets physician documentation with regards to procedure and diagnosis code selection.
* Identifies discrepancies between the physician code selection and the medical record documentation; corrects them, and presents findings and education to the appropriate physician.
* Performs scheduled audits of physician coding and documentation to make recommendations for improvements and enhancements.
* Maintains a close working relationship with assigned physicians and medical office, frequently querying the physician when coding discrepancies arise.
* Researches any coding questions the physician or medical staff may have, and presents findings to them.
* Codes hospital cases by reviewing the procedure reports, other documentation, and the assignment of diagnosis and procedure codes, releasing charges within the Epic system.
* Demonstrates a high skill level in correlating generalized observations/symptoms to a stated diagnosis to assign the correct ICD
* code.
* Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA) and the Center for Medicare & Medicaid Services (CMS) with regards to the assignment of ICD
* CPT, and HCPCS codes, including knowledge of the 95/97 Evaluation & Management billing guidelines.
* Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.
* Reviews Advanced Beneficiary Notices (ABNs) and confirms that the form is valid with regards to the information entered on it.
* Provides education to the appropriate medical office when discrepancies are identified.
* Reviews encounter forms, identifies any issues with the forms, and corrects them before posting charges.
* Works with Business Office staff in developing efficient coding processes and researching denials.
* Maintains an in-depth knowledge of Epic ambulatory and hospital modules.
* Stays current regarding knowledge of updated regulations, laws, and new procedures.
* Assists with all coding functions at or above the level of a Medical Coding I job summary.
* Maintains patient confidentiality.
* Attends all mandatory in-services and department meetings.
* Maintains a professional appearance and encourages behavior appropriate for a healthcare setting.
* Consistently demonstrates a self-directed, mature, disciplined and tactful approach to completing work duties.
* Provides spontaneous and accurate responses.
* On occasion, with the coordination of the supervisor adjusts workload.
* Understands and applies the Team Concept.
* CULTURE OF EXCELLENCE BEHAVIOR EXPECTATIONS
* To perform the job successfully, an individual should demonstrate the following behavior expectations:
* Quality
* Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
* Service
* Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.
* Partnering
* Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
* Cost
* Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue

What Does A Medical Coding Specialist Do At Kelly Services

* Ideally looking for experienced Risk Adjustment coder for Medicare Advantage, Commercial and ACA.
* Experience needed on how to read a medical chart and assign the correct diagnosis (ICD
* CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., HCC, CDPS, and HHS Risk Adjustment

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How To Become A Medical Coding Specialist

Health information technicians typically need a postsecondary certificate to enter the occupation, although some may need an associate’s degree. Certification is often required.

Education

Postsecondary certificate and associate’s degree programs in health information technology typically include courses in medical terminology, anatomy and physiology, health data requirements and standards, classification and coding systems, healthcare reimbursement methods, healthcare statistics, and computer systems. Applicants to health information technology programs may increase their chances of admission by taking high school courses in health, computer science, math, and biology.

A high school diploma or equivalent and previous experience in a healthcare setting are enough to qualify for some positions, but most jobs for health information technicians require postsecondary education.

Important Qualities

Analytical skills. Health information technicians must be able to understand and follow medical records and diagnoses, and then decide how best to code them in a patient’s medical records.

Detail oriented. Health information technicians must be accurate when recording and coding patient information.

Integrity. Health information technicians work with patient data that are required, by law, to be kept confidential. They must exercise caution and a strong sense of ethics when working with this information in order to protect patient confidentiality.

Interpersonal skills. Health information technicians need to be able to discuss patient information, discrepancies, and data requirements with other professionals such as physicians and finance personnel.

Technical skills. Health information technicians must be able to use coding and classification software and the electronic health record (EHR) system that their healthcare organization or physician practice has adopted.

Licenses, Certifications, and Registrations

Most employers prefer to hire health information technicians who have certification, or they may expect applicants to earn certification shortly after being hired. A health information technician can earn certification from several organizations. Certifications include the Registered Health Information Technician (RHIT) and the Certified Tumor Registrar (CTR), among others.

Some organizations base certification on passing an exam. Others require graduation from an accredited program. Many coding certifications also require coding experience in a work setting. Once certified, technicians typically must renew their certification regularly and take continuing education courses.

A few states and facilities require cancer registrars to be licensed. Licensure requires the completion of a formal education program and the Certified Tumor Registrar (CTR) certification.

Advancement

Health information technicians may advance to other health information positions by receiving additional education and certifications. Technicians may be able to advance to a position as a medical or health services manager after completing a bachelor’s or master’s degree program and taking the required certification courses. Requirements vary by facility.

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Medical Coding Specialist jobs

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Medical Coding Specialist Demographics

Gender

  • Female

    86.9%
  • Male

    11.8%
  • Unknown

    1.3%

Ethnicity

  • White

    79.2%
  • Hispanic or Latino

    11.1%
  • Asian

    7.2%
  • Unknown

    1.7%
  • Black or African American

    0.8%
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Languages Spoken

  • Spanish

    63.6%
  • French

    18.2%
  • Somali

    9.1%
  • Tamil

    9.1%
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Medical Coding Specialist

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Medical Coding Specialist Education

Medical Coding Specialist

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Top Skills for A Medical Coding Specialist

Cpt-4MedicalRecordDocumentationGuidelinesCPCEmergencyRoomAmbulatorySurgeryInsuranceCompaniesMedicalChartsAuditFacilityIcd-9-CmDiagnosisCodesClinicalDocumentationRadiologyIcd-10-CmInternalMedicineElectronicMedicalRecordsDataEntryE/MProcedureCodes

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Top Medical Coding Specialist Skills

  1. Cpt-4
  2. Medical Record Documentation
  3. Guidelines
You can check out examples of real life uses of top skills on resumes here:
  • Reviewed physician reports and charge sheets; applied correct CPT-4 and ICD9CM codes.
  • Assessed the adequacy of medical record documentation to ensure it supports all reportable diagnoses and procedures.
  • Apply understanding of CMS documentation guidelines assuring compliance.
  • Utilized HCPCS level III, ICD-9 and-3 for the coding.
  • Code Injections and Infusions for Emergency Room using the hierarchy table.

Top Medical Coding Specialist Employers

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