Role Description
Under direct supervision, assigns accurate ICD-10 diagnoses, CPT-4 procedure coding and appropriate modifiers derived from medical record documentation for complex and multi-specialties that include:
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Emergency Room (ER)
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ER E/M charging
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OP Trauma
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Hospital and ASC Surgeries
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Observation
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Interventional Radiology (IR) & Cardiology
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Claim Edits for facility outpatient encounters
This role is essential for ensuring accurate and timely coding of medical records which directly impacts reimbursement and compliance. This role requires expertise in coding guidelines and standards and proficiency in medical coding and the ability to handle moderate to complex coding scenarios.
Qualifications
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Associate or bachelorβs degree is preferred.
Requirements
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Serves as a clinical coding subject matter expert and utilizes critical thinking to analyze and evaluate moderate to complex outpatient documentation for the accurate assignment of ICD-10 and CPT-4 codes.
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Identifies and assigns ICD-10 diagnosis codes, CPT-4 procedure codes and appropriate modifiers.
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Monitors assigned work daily to facilitate the billing process within established timeframes.
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Codes and abstracts records within timeframes established for each patient type.
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Maintains coding quality accuracy rate of 90%.
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Maintains productivity rate of at least 95%.
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Communicates with various departments regarding billing and registration issues.
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Complies with AHIMA standards of ethical coding and coding compliance guidelines.
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Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies.
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May provide support to PB Outpatient Coding Specialists and/or act as backup, as necessary.
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Perform related duties as assigned.
Knowledge, Skills, & Abilities
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Ability to utilize coding and EHR software (e.g., EPIC, 3M HDM) efficiently.
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Knowledge and good understanding of NCCI edits, NCD & LCD requirements, and payer guidelines.
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Strong analytical, organizational, and attention to detail skills.
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Ability to prioritize workload, meet deadlines, and work effectively under pressure.
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Excellent customer service skills.
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Knowledge of general office procedures and filing systems.
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Strong problem-solving skills.
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Ability to work under minimal supervision.
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Familiar with basic medical terminology.
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Strong computer skills and typing ability.