Coding Specialist

Job Description
Understands and applies the basic fundamentals and conventional guidelines for ICD-CM coding. Due to the significant impact of regulation on hospice coding and the financial impact of filing the Hospice Notice of Election (NOE) timely; it is imperative that the Hospice Coding Specialist, in collaboration with the Documentation Specialists and Support Nurse; reviews, interprets, and analyzes clinical documentation precisely and efficiently in order to assign accurate and complete ICD-CM codes.

Job Overview
Understands and applies the basic fundamentals and conventional guidelines for ICD-CM coding. Due to the significant impact of regulation on hospice coding and the financial impact of filing the Hospice Notice of Election (NOE) timely; it is imperative that the Hospice Coding Specialist, in collaboration with the Documentation Specialists and Support Nurse; reviews, interprets, and analyzes clinical documentation precisely and efficiently in order to assign accurate and complete ICD-CM codes. Confers with RN Case Managers, Admission Nurse, and or attending physician as needed to seek clarity of information provided in the medical record. Complies with all CMS, federal, state laws and regulations and private insurance guidelines and requirements. Demonstrates strong organizational, analytical, and critical thinking skills. Communicates effectively, as the Hospice Coding Specialist works closely with all departments within the organization such as: the Compliance Department, Referral Center, Admissions, Nursing, the Business Office and Hospice Physicians.

Job Requirements
High School Diploma or GED (Required)

Proficient in ICD-CM coding

Medical terminology

Anatomy/physiology

Disease processes

Pathophysiology

Pharmacology and legal/ethical issues related to coding

Other RHIT - Registered Health Information Technician Upon Hire Required

Other CCS-Certified Coding Specialist Upon Hire Required
Other CCA - Certified Coding Associate Upon Hire Required

Job Responsibilities
Establishes good interpersonal relationship with all members of the hospice team. Communicates effectively. Communicates any identified problems/issues to the Department Manager in a timely manner so that appropriate corrective actions can be taken.

Reviews and analyzes the clinical record, H&P, diagnostic testing reports and other available documentation paying close attention to detail in order to assign appropriate ICD-CM codes in the EMR for billing purposes. Confers with clinical nursing staff, the patient attending physician and hospice medical director to seek clarification of information in the medical record ,as applicable, in order to verify diagnosis codes.

Serves as a resource for other departments within HOC on coding related issues. Answers questions promptly and offers guidance in identifying appropriate ICD codes to support hospice eligibility. Provides coding support and training to staff to ensure the accuracy and precision of the coding process.

Supports coding supervisor in assisting coding staff in resolving coding issues that arise within the patient accounting departments and provides coding support and training to providers, clinical support, and administrative staff to ensure the accuracy and precision of the coding process

Works collaboratively with the hospice Business Office and other staff as applicable to resolves coding issues that arise on billing claims. Informs the Compliance Manager in a timely manner when billing issues due to inaccurate coding arise.

Working Conditions
Bending -

Climbing - Rarely

Concentrating - Consistently

Continuous Learning - Consistently

Hearing: Conversation - Frequently

Hearing: Other Sounds -

Interpersonal Communication - Consistently

Kneeling - Occasionally

Lifting