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Certified Coding Specialist

2 months ago

Shenandoah, Iowa, United States Shenandoah Medical Center Full time
Job Overview

1. Precision in Coding and Documentation

The role involves meticulous coding and sequencing of diagnoses and procedures in accordance with established coding standards, ensuring accurate clinical information is abstracted for optimal reimbursement.

  • Examine medical records to ascertain the diagnoses and procedures conducted.
  • Assign appropriate charge master codes and modifiers for accurate billing and sequencing.
  • Utilize various information systems to correctly select patient accounts for billing purposes.
  • Engage in audits to identify lost charges and assess the accuracy of billing and coding practices.
  • Maintain ongoing communication with staff and providers regarding any missing or incorrect documentation.
  • Collaborate with departments to address and resolve billing discrepancies.
  • Work closely with healthcare providers and compliance teams to identify documentation changes that may enhance reimbursement opportunities.

2. Commitment to Professional Development

Demonstrate ongoing professional growth by setting personal educational goals to uphold coding knowledge and comply with regulatory standards, while participating in opportunities that ensure adherence to the highest professional standards and quality care delivery.

  • Develop and execute a self-improvement plan to fulfill continuing education requirements for certifications such as CPC, COC, CCS, and CCS-P.
  • Exhibit strong organizational skills, self-motivation, and adaptability in achieving personal, professional, and institutional goals.
  • Stay informed about national coding standards, including NCCI, JCAHO, and CMS regulations relevant to coding and billing.
  • Keep abreast of updates in ICD-10 CM/PCS, CPT-4, and HCPCS codes, providing insights and education on changes to billable items.
  • Organize data to identify documentation trends, offering feedback to staff and healthcare providers to enhance the capture of billable services.

3. Adherence to Policies and Procedures

Follow all relevant policies, procedures, and regulatory requirements while fulfilling additional job responsibilities as assigned.

  • Ensure compliance with departmental and organizational policies, as well as regulatory mandates (such as OSHA, CMS, and Joint Commission).
  • Participate in safety and quality initiatives at both corporate and departmental levels.

4. Additional Responsibilities

Perform other duties as assigned, contributing to the overall efficiency and effectiveness of the department.