Job Description

Under established coding principles and procedures reviews, analyzes, and validates the diagnostic and/or procedural codes applied from front-end coding and clinical teams for reimbursement and billing purposes. The CBO Coding Certified Specialist accurately abstracts information from the electronic health record for compilation of a patient database, which supports medical research projects, patient care evaluation, and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensure compliance with established coding guidelines, third party reimbursement policies, and regulation and accreditation guidelines.

Qualifications

REQUIRED:

• High school diploma or G.E.D. equivalent
• Thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, and pharmacology
• Proficiency in ICD-10 CM, CPT, and HCPCS coding systems

CERTIFICATIONS/LICENSURES REQUIRED:

• Registered Health Information Technician (RHIT) certification, RHIT certification eligibility, or one of the following: CPC, CPC-A, CCS, CCP, or CCA certification

PREFERRED:

• Some college coursework or degree in Accounting, Business, Healthcare Administration, or Medical Record Sciences
• Six (6) months of prior coding experience
• Prior experience in a healthcare revenue cycle position
• Billing or coding experience

CORE COMPETENCIES:

• Strong organizational and time management skills with ability to prioritize work effectively
• Effective communication with colleagues, supervisors, and managers
• Ability to work independently and remotely
• Proficiency in medical terminology
• Ability to recognize patterns and trends and escalate findings to supervisors for root-cause analysis
• Ability to assist and support team members
• Commitment to legal and ethical guidelines as outlined in the HFHS Code of Conduct