Quality Assurance Specialist III
Job Description:
- Assigns ICD-10-CM, ICD-10-PCS, and/or CPT codes.
- Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.
- Communicates with and provides feedback to the education team and/or providers.
- Reviews patient charges to determine necessary coding to complete the account.
- Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.
- Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
- Sequences diagnosis and procedures to generate appropriate billing.
- Queries physicians to obtain diagnosis if not clearly provided in records.
- Utilizes other available resources for assignment of codes as necessary.
- Assists other coders in resolving coding problems.
- Provides ICD-10 and CPT, for physician research projects, and for quality reporting purposes.
- Completes abstracts for records as appropriate.
- Assists in correction of problem accounts.
- Reviews charts for completeness.
- Participates in education and maintains certification.
- Assists in auditing records.
- Maintains concurrent coding for inpatient records.
Requirements:
- Required H.S. Diploma or equivalent
- Required Licenses/Certifications: CCA, CCS, CCS-P, CIPC, COC, CPC, CRC, RHIA, RHIT
- Required 4 years coding experience with preferred experience using an encoder and experience using an electronic medical record
- Preferred Skill: Prior experience in Hematology and Oncology coding is required. Certified Hematology and Oncology Coder (CHONC) credentials are preferred.
Benefits:
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development