This position performs complex professional coding in support of specialty or multi-specialty physician practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance with nationally recognized coding guidelines.
Reviews and analyzes complex diagnosis and procedure documentation from medical records against billed procedures to ensure accurate coding of specialty diagnoses and procedures in accordance with national coding guidelines and appropriate reimbursement requirements. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.
Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate review of ICD9 and/or CPT4 code assignments.
Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.
Acts as a knowledge resource to clinical staff for billing code issues.
High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associates degree in a related health care field.
Must demonstrate an elevated level of knowledge and understanding of ICD9 and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as required for the assigned practice areas. Requires three or more years of specialized professional coding experience for clinical specialty areas. Must be able to achieve an acceptable accuracy rate on the coding test administered by the hiring business unit according to pre-established company standards. Requires the ability to work autonomously while maintaining a high level of accountability and quality performance outcomes. Must demonstrate excellent critical thinking and organization skills. Requires attention to detail.
Must be able to work effectively with common office software, coding software, and abstracting systems.
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credentials are preferred. Medical Coding Specialty Credential from the American Academy of Professional Coders (AAPC) in the assigned specialty areas are a plus.Specialty coding certification.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.