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Coding Edit

2 months ago

Remote, Oregon, United States Driscoll Children's Hospital Full time

Where compassion meets innovation and technology and our employees are family.


Thank you for your interest in joining our team Please review the job information below.


General Purpose of Job:

Ensures that coding compliance initiatives are met with all record types. Reviews and analyzes medical records, CPT, ICD-10 data submitted by the coding and charge entry staff to determine the accuracy of code assignment and adequacy of clinical documentation according to regulatory requirements. Performs daily internal reviews to ensure accuracy in the ever-changing environment of coding, edits, documentation, denials, and impact to reimbursement. Able to compliantly resolve code edits and inpatient/outpatient denials or provide justification for code assignments, edits, train, and educate on all types of coding edits and denials to provide timely coverage to ensure accuracy, stability, and efficiency in our revenue cycle.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.

  • Maintains utmost level of confidentiality at all times.
  • Adheres to hospital policies and procedures.
  • Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
  • Successfully perform coding quality reviews to validate correct coding and modifier assignment in accordance with official National Correct Coding Initiative.
  • Provide feedback and trends to HIM/Coding, Patient Financial Services, and Revenue Integrity Dept staff regarding review results.
  • Maintain ongoing communication with management to ensure coding compliance goals are met.
  • Prepare edit and denial tracking and trending reports.
  • Assist management in the analysis of edit and denial tracking and trending reports.

Education and/or Experience:

  • Associate's degree (A. A.) or equivalent from two-year college or technical school; or two to three years related experience and/or training; or equivalent combination of education and experience.
  • Bachelor's degree (B. A.) from four-year college or university; or two to three years related experience and/or training; or equivalent combination of education and experience preferred.

Certificates, Licenses, Registrations.

  • CCS/CCS-P/CPC required.
  • CDIP/CCDS preferred.
  • RHIA or RHIT optional.