Overview :
Serves as the resident dynamic coding analyst in order to maintain a high coding standard within the department. Organizes and plans projects to improve the effectiveness of dynamic coding that crosses interdepartmental lines.
Performs analysis for dynamic coding improvement to include PFS systems edits and coding validation related to CDM (CPT / HCPCS code applications) and other processes which affect reimbursement and the CDM.
Assists in focused investigations and / or facilitates communication and cooperation to enhance the charging processes. Educates departments on appropriate charging / billing / coding issues to ensure regulatory compliance.
Serves as a resource for special projects for the analysis of data elements.
Qualifications : Required Education :
Required Education :
High School Diploma or GED
Preferred Education :
A.A. or specific certifications in field as required by department.
Necessary Skills :
1. Extensive knowledge in CPT and HCPCS coding, third party billing and reimbursement.
2. Ability to interpret and apply regulations and information obtained from various State and Federal sources.
3. Ability to explain to appropriate personnel how their chargemasters translate into codes that translate into reimbursement.
4. Proficient in Excel spreadsheets and Word processing applications.
5. Ability to work independently and use good judgment when making decisions / recommendations regarding changes / additions and / or corrections to the chargemaster.
6. Must be considered a resource to all departments regarding charge items / services / procedures.
7. Working knowledge of specific departmental procedures as required by supervisor
Required Licensure / Certifications :
One of the following certifications :
Certified Professional Coder (CPC)
Certified Professional Coder-Hospital Outpatient (CPC-H)
Certified Outpatient Coder (COC)
Certified Coding Specialist (CCS)
Registered Health Information Technician (RHIT)
Required Experience :
1-2 years experience in healthcare coding
Preferred Experience :
Business orientation and understanding of charge capture systems and processes. Understanding of current facility systems.
Knowledge of hospital operations, hospital department charge capturing, revenue cycle services and CMS regulations.
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