Job Type

Full-time

Description

The Hospital Coding Specialist II at Riverside Healthcare is responsible for accurately coding and abstracting complex outpatient, observation, and ambulatory procedure medical records. This position ensures complete and compliant coding of assigned accounts to meet reimbursement, indexing, statistical, and reporting requirements and will demonstrates flexibility with assignments within professional scope/duties/licensure. The Specialist will also assist with end-of-month and error reconciliation processes, including retrospective verification of medical necessity. The ideal candidate must be able to work independently in a fast-paced environment, prioritize tasks effectively, and adapt to shifting needs. A mature, customer-focused attitude and professional demeanor are essential for success in this role.

Essential Duties

• Accurately assign and sequence appropriate ICD-10-CM and CPT codes for all diagnoses, procedures, signs, symptoms, and conditions documented in medical records.
• Assign appropriate modifiers to CPT codes to fully describe the services rendered.
• Participate in the coding of complex outpatient, observation, and ambulatory procedure medical records.
• Assist with end-of-reporting-period tasks, backlog completion, medical necessity verification, and error reconciliation processes.
• Collaborate with Patient Financial Services and source departments to achieve accurate, timely coding and billing.
• Enter abstracted data into the Affinity system, ensuring that all information is accurate and complete.
• Classify cases into correct patient classification systems, such as APC (Ambulatory Payment Classifications) and EAPG (Enhanced Ambulatory Patient Groups).
• Link procedure codes assigned during the coding session to the correct operative episode, physician, and revenue code.
• Review and respond to APC, Outpatient Code Editor (OCE), Correct Coding Initiative (CCI), and medical necessity edits identified during the encoder session to achieve compliant coding and optimize reimbursement.
• Verify that all physicians involved in the patient's care are correctly documented in the abstract.
• Participate in assigned charge capture committees, contributing to efficient charge capture processes.
• Actively participate in ongoing continuing education opportunities to improve job performance and maintain coding credentialing.
• Adhere to recognized coding guidelines and standards in all aspects of work.
• Complete or reassign records within coding queues to reflect the status of each account"

Requirements

Required Experience

• Minimum of three (3) years of current ambulatory procedure coding experience in an acute care setting or a comprehensive ambulatory surgery center.
• Expertise in ICD-10-CM and CPT coding principles is essential.
• Thorough knowledge of Official Coding Guidelines.
• Strong background in medical terminology, human anatomy/physiology, pathophysiology, and disease processes.
• Proficient in Microsoft
• Ability to read and write in English.
• Detail-oriented with a commitment to accuracy and strong problem-solving abilities.

Preferred Experience

• Ability to work independently in a fast-paced environment and effectively manage multiple tasks.
• Expertise in applying official coding guidelines and assigning accurate codes for complex outpatient, observation, and ambulatory procedures.
• Excellent interpersonal and customer relations skills with a professional demeanor in all interactions.
• Proficiency in using computer systems for data entry and record-keeping.
• Ability to collaborate effectively with other departments, including Patient Financial Services, to ensure accurate coding and billing processes.
• Strong attention to detail with a commitment to accuracy in all aspects of coding and abstracting.

Required Licensure/Education

• Coding credential (or eligible status) is required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), and/or Certified Professional Coder - Hospital (CPC-H).
• If the candidate does not currently hold a coding credential, they must achieve certification within six months of hire.

Employee Health Requirements

Exposure to:

Chemicals: Printer, copier, and fax toners; liquid paper

Video Display Terminals: Extreme

Blood and Body Fluids: None

TB or Airborne Pathogens: None other than normal hospital environment exposure.

Sensory requirements (speech, vision, smell, hearing, touch):

Speech: Telephone and in person communication with customers, physicians, staff, and peers.

Vision: View computer screen, medical records, reports; access and review hard copy &online references &resources; file and retrieve records; identify and copy requested documents; prepare and distribute reports

Smell: N/A

Hearing: Telephone and in person communication with customers, physicians, staff, and peers; hear and respond to telephone, overhead pages, and emergency announcements; participate in inservice and continuing education programs

Touch: Write, keyboard; file/retrieve documents, reports

Activity/Lifting Requirements:

Average Hours per Week: 40

Shift: Varies

Percentage of time during the normal workday the employee is required to:

Sit: 88%

Twist: 0%

Stand: 2%

Crawl: 0%

Walk: 3%

Kneel: 1%

Lift: 2%

Drive: 0%

Squat: 1%

Climb: 1%

Bend: 1%

Reach above shoulders: 1%

The weight required to be lifted each normal workday according to the continuum described below:

Up to 10 lbs: Frequently

Up to 20 lbs: Frequently

Up to 35 lbs: Occasionally

Up to 50 lbs: Not Required

Up to 75 lbs: Not Required

Up to 100 lbs: Not Required

Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.): Stacks of charts, supplies carried waist high approximately 300 ft. May have to carry records up/down circular staircase. Carrying/lifting/bending with charts to file or retrieve in various department locations. Carrying paper/file folders through department. Reams of paper to printers/photocopier

Repetitive use of hands (Frequency indicated): Simple grasp up to 10 lbs.

Normal weight: 5- 10lbs

Frequent Pushing &pulling: Normal weight

Fine Manipulation: Writing instruments, clips, fasteners, stapler &staple remover; keyboarding, filing/retrieval, copying, folder creation, record review, sorting, accessing reference materials.

Repetitive use of foot or feet in operating machine control: None

Environmental Factors & Special Hazards:

Environmental Factors (Time Spent):

Inside hours: 8

Outside hours : 0

Temperature: Normal Range

Lighting: Average

Noise levels: Average

Humidity: Normal Range

Atmosphere: Dust

Special Hazards: Protective Clothing Required: None

Salary Description

$25.43-$31.78/hr