[Hiring] Professional Coding Specialist III - Cardiothoracic Surgery @WVU Medicine

Role Description

Reviews all surgical documentation to assign accurate ICD-10, CPT, HCPCS codes, and modifiers for complex procedures performed throughout WVU Medicine. Complies with national coding guidelines to ensure that all procedures are coded accurately and consistently. Applies coding conventions and rules established by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) when assigning procedural, diagnostic, and HCPCS codes to ensure that they are in accordance with CCI edits, MUE edits, LCD, and NCD’s. Contacts & collaborates with appropriate personnel for documentation insufficiencies and to expedite resolution of accounts.

Qualifications

• High School Diploma or Equivalent.
• Current HIM/Coding Certification through one of the following:
  • American Health Information Management Association (AHIMA)
  • American Academy of Professional Coders (AAPC)
• Must obtain Specialty Medical Coding Certification through the American Academy of Professional Coders (AAPC) within one (1) year of hire.
• Associates degree in Health Information Management (Preferred).

Requirements

• Three (3) years of medical coding experience to include one (1) year of advanced surgical coding experience.
• Four (4) years of coding experience (Preferred).

Core Duties and Responsibilities

• Accurately codes and/or audits complex surgical procedures as part of daily workload (85%-95% of workload) including but not limited to:
  • Bariatric surgery
  • Cardiothoracic surgery
  • Gynecologic surgery
  • Oncology surgery
  • Orthopaedics surgery
  • Thoracic surgery
  • Transplant surgery
  • Trauma and burn surgery
  • Open Vascular surgery
• Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified.
• Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas.
• Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals.
• Assures the accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or any persons necessary to obtain information required to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process.
• Monitors on an ongoing basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed.
• Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts.
• Analyzes and resolves issues of missing charges and problem accounts by researching information regarding department reimbursement.
• Interacts with physician and non-physician providers to maximize correct coding initiatives.
• Maintains a level of expertise and ever expanding knowledge in coding and sequencing guidelines to ensure that all healthcare information is accurately assigned and appropriate.

Physical Requirements

• Must be able to sit for long periods of time.
• Must have visual and hearing acuity within the normal range.
• Must have manual dexterity needed to operate computer and office equipment.
• Must be able to lift, push or pull 10-20 pounds.

Working Environment

• Standard office environment.
• Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.
• May require travel.

Skills and Abilities

• Must be able to concentrate and maintain accuracy during constant interruptions.
• Must possess independent decision-making ability.
• Must possess the ability to prioritize job duties.
• Must be able to handle high stress situations.
• Must be able to adapt to changes in the workplace.
• Must be able to organize and complete assigned tasks.
• Must possess excellent written and verbal communication skills.
• Must meet quality and productivity standards.
• Must possess the knowledge of anatomy, physiology and medical terminology.

Additional Job Description

Looking for a dedicated Cardiothoracic Surgery coder. Types of procedures responsible and skillset for (list does not include all possible procedures):

• CABG procedures
• Valve surgeries (Valvuloplasties, valve replacements, enlargements, etc)
• Aortic Arch repair procedure
• Bedside: ECMO - daily management, cannulation, initiation, repositioning, decannulation.
• LVAD daily interrogations, Moderate sedation.

Scheduled Weekly Hours

40

Shift

Exempt/Non-Exempt: United States of America (Non-Exempt)

Company

West Virginia University Health System

Cost Center

539 SYSTEM HIM Provider Based Coding Analysis