Coding Specialist

3 weeks ago


Wyoming, United States University of Michigan Health-West Full time

Coding Specialist - Wound Center - Wound Clinic
- Days - 36hrs/wk.

Requisition #: req7985

Shift: Days

FTE status: 0.9

On-call: No

Weekends: No

**General Summary**:
Under direction of the Wound Center Director, the Coding Specialist - Wound Center (WC) is responsible for accurately coding outpatient conditions and procedures for accurate interfacing from iHeal (WC EMR) to the hospital’s EPIC system. The Coding Specialist - Wound Center reviews clinical documentation and diagnostic results to extract data for billing, internal and external reporting, and research, ensuring all codes are appropriately applied per the ICD-10-CM Official Guidelines for Coding and Reporting. This role is also responsible for other administrative tasks directly linked to coding under the discretion of the Wound Center Director.

**Requirements**:

- High school diploma or equivalent
- Coding certificate preferred
- Medical Assistant experience preferred (MA)
- Previous EMR/Coding software and computer experience.
- Ability to understand and explain CPT, ICD-10 and HCPCS code books and Wound Center Revenue Cycle Management guidelines.
- Data entry
- Analyzing information
- Strong written and oral communication skills
- Ability to contribute to team-based projects and initiatives
- Strong customer service
- Problem solving skills
- Strong understanding of medical terminology

**Essential Functions and Responsibilities**:
**Coder**
- Code all Wound Center-based diagnoses, treatments, and procedures by translating physician and nursing documentation according to the appropriate classification system for iHeal to EPIC interfacing.
- Maintains appropriate coding queries process as appropriate and manually scans documents through the interface, as needed.
- Maintain knowledge and adherence to Healogics, UMH-West compliance regulations and other applicable governing bodies.
- Work with Patient Financial Services, Fiscal Services, Information Services, Transcription, Health Information Management and CVS department management and staff regarding correct reporting, coding, and charge entry practices
- Maintain exceptional coding accuracy based on hospital and regulatory expectations.
- Assist providers and other WC care professionals with questions regarding level of detail for diagnostic entries, according to the guidelines.
- Foster respect for patient privacy by maintaining confidentiality in all phases of the work.
- Participate in departmental quality standards, including auditing WC charges and related issues.
- Performs other coding duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by leadership.

**Administrative Specialist**
- Facilitates the department’s prior authorization process. Collaborates with peers as appropriate to ensure timeliness for patient access.
- Operates as the point person for product ordering, including specialty items to ensure optimal billing and reimbursement is achieved.
- Collaborates with clinical team to order and manage supply of skin substitute products, beginning with benefit verification process.
- Maintains active patient list reporting to ensure data integrity and appropriate patient status.
- Other duties as assigned.


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