Reviews, determines accuracy of and applies the correct coding conventions to patient charge encounters, procedural and surgical services, as defined through physician documentation, regulatory agencies and various third-party payers. Provides departmental specialty-specific education related to physician coding/compliance, non-physician practitioner coding/compliance and appropriate coding conventions for individual physicians, residents and to collective groups within the department.
Position Key Accountabilities:
- Assists with training of staff while performing routine correct coding applications utilizing ICD-9-CM, CPT-4, and HCPCS codes required for the patient charge encounters when reviewing physician generated codes, ensuring compliance with regulatory agencies, correct coding initiatives and regulatory guidelines for clinical documentation.
- Identifies and reports correct code selection from physician documentation, to include, but not be limited to; chart notes, abstracting from medical records documentation, medical diagnostic and/or interventional reports, ensuring compliant coding selections are reported within assigned department.
- Reviews and reports all denials related to coding, by report, assigning and indicating reason codes for coding denials.
- Assists in the delivery of appropriate specialty specific coding education for providers within their respective departments, including, but not limited to teaching physician guidelines for documentation, as requested.
- Identifies provider specific educational needs relative to professional coding and documentation.
- Meets with providers/residents to provide focused educational reviews to enhance compliance, as directed by supervisor.
- Attends and participates in all coding related educational activities, as directed by the Department of Billing and Compliance Coordination and disseminates applicable information to departmental physicians/residents, and staff within the department.
- Act as a resource in the clinic setting for providers, practitioners, for queries related to coding convention and compliance questions.
- Other duties as assigned.
Certification/Skills:
- Certified Professional Coder (CPC) by the American Academy of Professional Coders or
- Certified Coding Specialist-Physician (CCS-P) by the American Health Information Management Association or
- Registered Health Information Administrator (RHIA)/ Registered Health Information Technician (RHIT) by the American Health Information Management Association.
- Must complete certification within 12 months of employment at UTHSC-H. Monitoring of certification is department’s responsibility.
Minimum Education:
- High School diploma or equivalent
Minimum Experience:
- Four years of related experience.
- May substitute required experience with equivalent years of education beyond the minimum education requirement.
Physical Requirements for this position: Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects. This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215
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