Job Information
First Health of the Carolinas Clinical Coding Specialist III in Pinehurst, North Carolina
Clinical Coding Specialist III Thoroughly reviews the entire medical record to specifically and accurately code those diagnoses and procedures that were treated or affected patient’s plan of care. Verifies that the record contains appropriate documentation to justify the codes assigned. Assists with auditing medical records for quality of coding and to ensure appropriate reimbursement and reports findings to Coding Coordinator. Will be able to serve as backup for coding, billing, abstracting, and/or auditing of Outpatient and ED records. This specialist will be responsible for remaining current on all ICD and CPT coding changes as well as payer specific requirements and regulations. Qualifications The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this position. Education/formal training/licensure/certification/experience: · Degree in HIM. RHIA or RHIT preferred; CCS required. · 4 years coding experience in hospital setting (at least 2 years inpatient) · Experience in DRG validation or chart auditing preferred · Thorough understanding and experience in both ICD-10 and CPT 4 required · Minimum of 90% score on competency assessment · Must be consistently exceeding standards of Level II and/or score minimum of 90% on competency sampling