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Form of workJob Description
*This is a hybrid position in Columbia, MO*
Nucleus Healthcare is seeking a Certified Medical Coding Specialist to join a prestigious academic health system in Columbia, MO. Our partner is committed to providing exceptional care when and where it’s needed by increasing access to primary care and specialty providers.
This health system also values the importance of work-life balance and professional growth by providing a supportive and empowering work environment for all employees. Take the next step in your career and thrive in an environment where you are respected, challenged, and able to grow your career path!
Benefits that matter.
Paid-for tuition from the local top-rated university.
Up to 75% for you and 50% for spouses and childrenRetirement options including 100% match up to 8%
100% paid leave for parents and caregivers for up to four weeks – effective January 2024
Comprehensive health and wellness benefits, including mental wellness support.
4 Personal Days, 12 Sick Days, 17 PTO days for 0-5 years, and 22 PTO days for 5+ years
Job Description
The ideal candidate for the Medical Coding Specialist position will deeply understand Medical Coding systems and regulations, ensuring accurate and compliant coding for healthcare services. The Medical Coding Specialist will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM, ICD-10-PCS, and CPT codes for billing, internal and external reporting, research and regulatory compliance; complete audits of coding and billing for validation; and test coding applications. Other duties of the Medical Coding Specialist include, but are not limited to:
Review appropriate provider documentation to determine appropriate principal diagnosis, co-morbidities and complications, secondary conditions, and surgical procedures; utilizes technical coding principles and MS-DRG and APC reimbursement expertise to assign appropriate ICD-10 codes and/or CPT-4 codes. Reviews and when necessary, corrects the patient admission source, status, and disposition upon discharge. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to Official Coding Guidelines. Advances coding knowledge and practice through continuing education.
Extract required information from clinical documentation and enter it into the encoder and abstracting system, following the prescribed coding productivity standards.
Conduct regular audits to assess coding accuracy and identify areas for improvement.
Participate in testing and troubleshooting problems when implementing new applications or updates to existing systems.
Assists with training for new software applications.
Inpatient Coding Staff (in addition to the above):
Assign Present on Admission (POA) value for all inpatient diagnoses, and an External Cause code as appropriate.
Consult with the Clinical Documentation Specialist to resolve any unspecified or questionable diagnoses prior to final code assignment.
Determines whether a query must be sent to clarify ambiguous or unclear documentation.
Outpatient Coding Staff (in addition to the above):
Identify chargeable items for visits (i.e. IV infusions/hydration, GI procedures) and enter corresponding charges into the billing system appropriately.
Hold Bill and Denials Staff (in addition to the above):
Work inpatient and/or outpatient coding related bill alerts/edits/denials (i.e. NCCI, MUE, Medical Necessity, etc.), in accordance with established procedures.
Enter detailed notes to update the financial system if the alert/edit cannot be resolved or must be rerouted to another responsible party for research/resolution. Escalate alert/edit resolution issues as appropriate to minimize final billing delays.
May complete unit/department specific duties and expectations as outlined in department documents.
Knowledge, skills, and abilities include:
ICD-10-CM and CPT-4 coding conventions, CMS National Correct Coding Initiative Edits, Anatomy and Physiology, Medical Terminology, DRG/APC reimbursement, Coding software familiarity, Effective written and verbal communication skills, and Data entry.
Required Qualifications
One of the following certifications:
Certified Coding Associate (CCA)
Certified Coding Specialist (CCS)
Registered Health Information Technician (RHIT)
Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA); or
Certified Professional Coder (CPC/CPC-A)
Certified Outpatient Coder (COC/COC-A)
Certified Inpatient Coder (CIC/CIC-A) by the American Academy of Professional Coders (AAPC); or;
Specialty certification per the department needs such as:
Radiation Oncology Certified Coder (ROCC) by the American Medical Accounting and Consulting Inc. (AMAC)
Preferred Qualifications:
- Two (2) years of experience in coding for hospital or physician practice.
- Additional license/certification requirements as determined by the hiring department.
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About Nucleus
Nucleus Healthcare is a staffing and recruitment agency partnering with top-tier facilities and organizations to deliver quality candidates seeking meaningful employment. We have permanent placement and long-contract jobs nationwide in nursing, allied health, healthcare operations and hospitality, and life sciences. Our vision of redefining how healthcare does business fuels our mission to empower the people who power healthcare. Connect with a Nucleus recruiter today!
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