Coding Quality Review Specialist
MedStar Health
Date: 12 hours ago
City: Columbia, MD
Contract type: Full time
General Summary Of Position
Performs coding quality reviews on medical records
Primary Duties And Responsibilities
Education
Performs coding quality reviews on medical records
Primary Duties And Responsibilities
- Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
- Assists with the development of system-specific coding guidelines as needed, and participates in Quality review team meetings.
- Having knowledge of coding compliance plan, directs efforts to achieving plan by focusing on areas identified through coding reviews or targeted by management for improvement.
- Helps select areas for focused quality reviews.
- Maintains continuing education. Maintains credentials, for required job classification.
- Meets established Quality, Accuracy, and Productivity standards as defined by policies.
- Provides/identifies trends to provide feedback to appropriate sources. Identifies and assists in areas to provide additional training/education, under the direction of Manager.
- Responsible for retrospective and concurrent reviews on coding staff.
- Reviews, analyzes, and interprets medical record documentation to identify diagnoses and procedures. Assigns correct ICD and/or CPT diagnostic and procedural codes using standard guidelines and automated encoding software. Assigns the appropriate DRG.
- Works closely with the Coding Quality Review team and outpatient coding staff to identify areas for improvement and problematic cases.
- Participates in multi-disciplinary quality and service improvement teams
Education
- High School Diploma or GED required ; Bachelor's degree with successful completion of medical terminology, anatomy, physiology, and coding courses in ICD-10-CM and CPT-4 preferred
- 2 years outpatient coding experience, preferably in an acute care setting required; 1-2 years Auditing experience preferred
- CCS-P (Certified Coding Specialist- Physician) through AHIMA (American Health Information Management Association) required and either a CCS (Certified Coding Specialist) through AHIMA or COC (Certified Outpatient Coder) through AAPC (American Academy of Professional Coders) required
- Certification as a Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred
- Excellent verbal and written communication skills.
- Excellent interpersonal skills, Good public speaker and presenter.
- Basic computer skills preferred.
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