Clinical Coding Specialist - Pro Fee

Summary
Analyzes medical records and abstracts clinical data by assigning codes from patient records in accordance to coding classification systems. Reviews patient encounters for accurate code assignment of all relevant diagnosis and procedures. Enters appropriate codes into the hospital's mainframe computer for the transfer of data to billing files for reimbursement. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous or unclear for coding purposes. Serves as a resource for other departments users related to the abstracted coded data.
Key Functions

1. Analyzes medical records and abstract clinical data by assigning codes (ICD10, CPT, HCPCS) from patient records in accordance with coding classification systems.
2. Reviews patient encounters for accurate code assignment of all relevant diagnoses and procedures. Exports appropriate codes from CodeRyte and/or Epic charge systems.
3. Assign appropriate modifiers, and apply guidelines as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI).
4. Meet or exceed department production and accuracy standards.
5. Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, AAPC/AHIMA seminars, and other educational forums.
6. Queries physicians and/or departments when code assignments are not straightforward or documentation in the record is inadequate, ambiguous or unclear for coding purposes.
7. Resolves coding edits in Epic by performing second review of medical record documentation and code assignments.
8. Must be flexible and adapt to changing work assignments.
9. Must exercise good judgment in making decisions in regard to coding and/or auditing outcomes.
10. Possess a thorough knowledge and understanding of institutional coding policies and procedures; maintains knowledge of ICD-10-CM, HCPCS and CPT-4 coding guidelines according to CMS, AMA, AHA and other official sources.
11. Other duties as assigned

Working Conditions
This position requires:
Working in Office Environment
______ No
______ Yes
Working in Patient Care Unit (e.g. Nursing unit; outpatient clinic)
______ No
______ Yes
Exposure to human/animal blood, body fluids, or tissues
______ No
______ Yes
Exposure to harmful chemicals
______ No
______ Yes
Exposure to radiation
______ No
______ Yes
Physical Demands
Indicate the time required to do each of the following physical demands:
Time Spent
Never
0%
Occasionally
1-33%
Frequently
34-66%
Continuously
67-100%
Standing
Walking
Sitting
Reaching
Lifting/Carrying
Up to 10 lbs
10lbs to 50 lbs
More than 50 lbs
Pushing/Pulling
Up to 10 lbs
10lbs to 50 lbs
More than 50 lbs
Use computer/keyboard
Required Education:
Associate's degree in Health Information Management, Healthcare Administration, or related healthcare field.
Preferred Education:
Bachelor's degree.
Required Experience:
Two years of coding experience in a medical services environment or one year as a Clinical Coding Associate at M D Anderson Cancer Center . May substitute required education degree with additional years of equivalent experience on a one to one basis and no experience required with preferred degree.
Preferred Experience/Skills:
Knowledge and experience in Limited coverage determination (LCD) and National coverage determination (NCD), coding outpatient and inpatient professional services for Evaluation and Management -multispecialty with strong diagnosis coding experience, global rules for post-operative visits and knowledge of correct use of modifiers.
Other Requirements:
Must pass pre-employment skills test as required and administered by Human Resources.
License/Certification
One of the following Preferred:

• Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA).
• Registered Health Information Technician (RHIT) by the American Health Information Management Association (AHIMA).
• Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA).
• Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA).
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).
• Certified Professional Coder - Hospital (CPC-H) by the American Academy of Professional Coders (AAPC).

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Additional Information

• Requisition ID: 163979
• Employment Status: Full-Time
• Employee Status: Regular
• Work Week: Days
• Minimum Salary: US Dollar (USD) 55,500
• Midpoint Salary: US Dollar (USD) 69,500
• Maximum Salary : US Dollar (USD) 83,500
• FLSA: non-exempt and eligible for overtime pay
• Fund Type: Hard
• Work Location: Hybrid Onsite/Remote
• Pivotal Position: Yes
• Referral Bonus Available?: No
• Relocation Assistance Available?: No
• Science Jobs: No

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