Specialist-Coding Reimbursement

Provides expertise with accuracy of diagnosis and procedure coding as aligned to applicable code sets (ICD10CM, ICD10PCS, CPT, etc.) and industry guidance. Ensures timely awareness with pertinent annual or other industry coding/reimbursement updates. Promotes quality coding while serving as a daily internal resource to hospital Coding and CDI teams, and more. Regularly assesses and monitors coding practices to provide education and recommendations ensuring best coding accuracy, adherence to industry coding convention and all pertinent guidelines. Supports hospital coding team orientation and onboarding quality assessment processes or with those team members migrating to a new type/specialty coding. Supports success among broader BMHCC partnered initiatives with Quality and physician leadership, Patient Financial Services, Registration, Revenue Integrity, Clinical Documentation Integrity (CDI), Internal Audit, Compliance and Revenue Cycle/Finance, among others. Actively supports all coding quality program initiatives and related activities. This position requires extensive subject matter expertise across ICD10-CM, ICD10-PCS and CPT code sets, including all applicable industry guidelines and rules (ICD10-CM/PCS Official Guidelines for Coding & Reporting, AHA quarterly Coding Clinic publications, CMS National Correct Coding Initiative (CCI) and Local and National Coding Determinations (LCD/NCD) for reimbursement impact, and more). Performs other duties as assigned. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES FOR THIS POSITION Serves as subject matter expert (SME) for correct code assignment supporting BMHCC hospital coding, determining code assignment accuracy based on patient record documentation; and related quality, reimbursement, and other risk exposure impact. Assesses individual Coding Specialist skills proficiency for ICD10CM, ICD10PCS and/or CPT code assignment accuracy; compiles and reports findings. Facilitates new Coding Specialist onboarding and initial quality reviews in partnership with hospital coding operations leadership to assess, educate/train and ensure code assignment accuracy prior to new hire release to code independently. Facilitates existing Coding Specialist cross training to other specialties/types in partnership with hospital coding operations leadership; assesses, educates/trains and ensures code assignment accuracy with a newly trained specialty/type prior to releasing the coder to code independently. Collaborates regularly with coding operations teams, Clinical Documentation Improvement (CDI), Quality, physician leadership, Compliance, fellow Revenue Cycle and other department teams impacted by coding accuracy to best support BMHCC outcomes (national rankings, quality metrics or penalties, reimbursement, etc.). Provides ongoing research, analysis, and updates as needed among new regulatory or industry coding/reimbursement developments. Completes performance goals and others as indicated with designated project work among target/challenge metrics. Performs other duties as assigned. Education Associate's Degree Health Information Management or related field Required* Bachelor's Degree Health Information Management or related field Preferred Experience 3 years of relevant experience Professional experience in acute healthcare coding industry role Required Skills, knowledge, and abilities acquired through career experience including use of electronic health records, encoder and abstracting software, production coding and/or reviewing records for coding accuracy; compiling and communicating record review findings, and; educating/teaching. Required Proficiency coding inpatient and outpatient (ancillary, emergency department, day surgery, observation, etc.) records utilizing ICD10CM, ICD10PCS and CPT coding. Required One-year or more internal experience Served among BMHCC hospital coding operations team as Coding Specialist, Trainer, Lead, etc .Preferred Licenses and Certifications (active/current/valid/verified) Licenses/Certifications Licensure/Certification Host Entity Req/Pref And/Or Other Coding Specialist (CCS) American Health Information Management Association (AHIMA) Required And/Or *May consider CCS with relevant experience in lieu of Associate's Degree Registered Health Information Administrator (RHIA) American Health Information Management Association (AHIMA) Required And/Or Registered Health Information Technician (RHIT) American Health Information Management Association (AHIMA) Required Apply tot his job