Coding Specialist III

PRIMARY PURPOSE

The primary purpose of the Coding Specialist III is to code and verify data necessary to ensure correct coding, abstracting, and billing on inpatient (IP) encounters. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II and modifier codes for both professional and hospital charging, coding and billing.

Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland's policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered.

• High school diploma required.
• Must have successfully completed an approved coding program.
• OR Must be a graduate of a health Information Management program.

• Must have three (3) years of coding experience in an acute care Level I trauma hospital environment.
• Physician office coding, charging and billing experience preferred.

May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.

• Must be certified through the American Health Information Management Association as one of the following:
  • Registered Health Information Management Technician (RHIT)
  • Registered Health Information Management Administrator (RHIA)
  • Certified Coding Specialist (CCS) (Most desired of the certifications)

• Must be able to demonstrate advanced knowledge of ICD-9/ICD-10-CM/PCS coding and abstracting, MS-DRG classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage. Also prefer knowledge to apply CPT, HCPCS, HCC, HEDIS CAT II and modifier code assignment.
• Must score a minimum of 85% on a pre-employment coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
• Demonstrate knowledge of reimbursement (Medicare and Medicaid) principles.
• Advance knowledge of medical terminology, the human disease process, anatomy and physiology.
• Demonstrate good organizational and leadership skills.
• Must be able to effectively communicate, both orally and in writing.
• Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC).
• Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.