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TriHealth

Coding Specialist I

TriHealth, Norwood, Ohio, United States

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Job Overview This position abstracts provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers.

Job Requirements

High School Degree or GED

CPC-A, CPC, CCS-P, CCA

ICD-10-CM and CPT Coding Guidelines

Medical terminology

Anatomy

Physiology

Experience Related Fields

Job Responsibilities Assists with coding/billing questions from both internal and external customers, which will include follow up on denials, research, review of charts for potential coding issues. Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary. Communicate with other clinical staff regarding documentation trends. Maintains a close working relationship with all departments and internal customers including leadership and consolidates efforts to ensure appropriate and standardized coding procedures are followed. Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources. Maintains knowledge of current coding revisions and effectively communicates changes with provider. Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems. Validate and abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance where applicable. Ensure that all codes are current, active, and billable according to CCI.

Qualifications

Successful completion of a certification program from an accredited organization

Strong knowledge of anatomy, physiology, and medical terminology

Excellent typing and 10-key speed accuracy

Commitment to a high level of customer service

Superior mathematical skills

Familiarity with ICD-10 codes and procedures

Solid oral and written communication skills

Working knowledge of medical jargon and anatomy preferred

Able to work independently

Working Conditions

Climbing – Rarely

Concentrating – Consistently

Continuous Learning – Consistently

Hearing: Conversation – Consistently

Hearing: Other Sounds – Frequently

Interpersonal Communication – Consistently

Kneeling – Rarely

Lifting

Lifting 50+ Lbs – Rarely

Lifting 11-50 Lbs – Rarely

Pulling – Rarely

Pushing – Rarely

Reaching – Rarely

Reading – Consistently

Sitting – Consistently

Standing – Frequently

Stooping – Rarely

Talking – Frequently

Thinking/Reasoning – Consistently

Use of Hands – Occasionally

Color Vision – Rarely

Visual Acuity: Far – Frequently

Visual Acuity: Near – Frequently

Walking – Occasionally

TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:

Serve: ALWAYS…

Welcome everyone by making eye contact, greeting with a smile, and saying "hello"

Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist

Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS…

Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met

Offer patients and guests priority when waiting (lines, elevators)

Work on improving quality, safety, and service

Respect: ALWAYS…

Respect cultural and spiritual differences and honor individual preferences.

Respect everyone’s opinion and contribution, regardless of title/role.

Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS…

Value the time of others by striving to be on time, prepared and actively participating.

Pick up trash, ensuring the physical environment is clean and safe.

Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS…

Acknowledge wins and frequently thank team members and the others for contributions.

Show courtesy and compassion with customers, team members and the community

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