MD Anderson Cancer Center Quality Coding Specialist in Houston, Texas

Quality Coding Specialist

Location: United States, Texas, Houston, Houston (TX Med Ctr) at https://mdanderson.referrals.selectminds.com/jobs/13138/other-jobs-matching/location-only

Healthcare/Business Support at http://mdanderson.referrals.selectminds.com/landingpages/healthcarebusiness-support-opportunities-at-md-anderson-cancer-center-12

Finance Division 900134

Requisition #: 117542

Mission Statement

The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

Summary

The primary purpose of the Quality Coding Specialist position is to assign appropriate diagnosis and procedure codes to professional services that come through the Revenue Operations & Coding department. This position will be responsible for performing high level complex audit reviews for physician documentation. The auditor is to ensure charges submitted by the provider are in accordance with the coding and auditing rules and regulations, as set forth by the Centers for Medicare and Medicare Services, American Medical Association, as well as other payor and institutional guidelines.

Key Functions:

Essential functions of the job include, but not limited to:

  • Manually performs diagnosis and procedural coding by utilizing the International Classified Disease, Clinical Modification (ICD-10-CM) and the Current Procedural Terminology (CPT 4) classification systems to select appropriate codes.

  • Performs a designated number of departmental audits to identify trends and opportunities within the departments.Auditors demonstrate high decision making skills by reviewing the provider’s documentation to ensure compliance with the coding and documentation rules and regulations set forth by the American Medical Association, Centers for Medicaid and Medicare Services, as well other individual payers.

  • Auditors will use the MD Audit program to enter the results of their audits.

  • Auditors will perform charge corrections for those services that are not supported by the provider’s documentation; and subsequently, schedule meetings to provide education to those designated providers and departments.

  • Initiate consistent and ongoing education, including appropriate PowerPoint presentations and MD Audit reports, for each individual department as well as individual providers and others regarding the coding and/or auditing rules and regulations, or other pertinent issues related to coding.

  • Assign appropriate modifiers, and apply guidelines as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI).

  • Communicate effectively with providers and administrative staff using effective written and verbal communication skills, and demonstrating good interpersonal skills.

  • Collaborate with the Institutional Compliance Billing department on consistent auditing processes and for developing provider education strategies.

  • Compile reports with pertinent statistical data for review by management.

  • Meet or exceed department production & accuracy standards.

  • Report problems/concerns to management.

  • Must have the ability to work independently without close supervision.

  • Must exercise good judgment in making decisions in regard to coding and/or auditing outcome.

  • Must be flexible and adapt to changing work assignments.

  • Attend training & institutional classes to maintain current knowledge of coding & auditing rules.

  • Other duties, as assigned.

Education:

Required: Associates Degree in Health Information Management, Healthcare Administration, or related healthcare field.

Preferred: Bachelor’s Degree in Health Information Management, with specific knowledge in ICD-10, CPT 4 and Evaluation & Management auditing experience.

License/Certification:

Required: Certification in one of the following:

  • Certified Professional Coding (CPC) by the American Academy of Professional Coders

  • Certified Coding Specialist-Physician Based (CCS-P) by the American Health Information Management Association

  • Registered Health Information Administrator (RHIA) by the American Health Information Management Association.

  • Registered Health Information Technician (RHIT) by the American Health Information Management Association.

  • Certified Coding Specialist (CCS) by the American Health Information Management Association.

  • Certified Professional Coder - Hospital (CPC-H) by the American Academy of Professional Coders.

Experience:

Required: Five years of clinical coding experience for complex multi-specialties, to include three years of evaluations and management coding experience or three years of documentation auditing. May substitute required education degree with additional years of equivalent experience on a one to one basis. Must pass pre-employment skills test as required and administered by Human Resources.

Preferred: Six years multi-specialty coding with three years E/M governmental auditing.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html