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Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement.
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Perform proficiently in all competency areas including but not limited to: medical coding, auditing, clinical records, privacy official responsibilities, supervisory responsibilities, patient rights, and safety and sanitation.
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Associates degree in Health Information Management with RHIT (Registered Health Information Technician) or RHIA(Registered Health Information Administrator)ORCCS (Certified Coding Specialist) or CCS-P (Certified Coding Specialist Physician Based)/ or CPC (Certified Professional Coder.
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Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC, or CIC) As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment.
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Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation. Advanced knowledge of medical coding, electronic medical record systems, coding systems.
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Current RHIT, RHIA, CCS, CPC-H, CPC-A, CIC or CCS-P preferred or obtained within one year plus a passing score on the Coding test. High School Diploma or GED and courses in Medical Terminology, Anatomy & Physiology and Pharmacology.
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The Medical Records Director (Non-Nurse) maintains the patients’ clinical records, including coding, auditing, and providing pertinent staff education regarding recordkeeping procedures in accordance with all applicable laws, regulations, and Life Care standards.
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Knowledge of current and developing issues and trends in medical coding diagnosis and procedure code assignment. Review pre-bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment.
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Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, and client denials. Attends in-house training sessions to receive updated coding information and changes in coding and/or regulations.
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Utilizes Accuity technology for tracking of coding errors, query opportunities and other data collection as needed. Minimum 4 years of inpatient coding experience in hospital facility coding.
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Courses/training to include medical terminology, anatomy & physiology, and coding and classification systems preferred. Current RHIT or RHIA registration and CCS/CPC-H is required.
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Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. The Provider Education Coordinator serves as a subject matter expert for documentation and coding and utilizes expertise to analyze revenue cycle metrics to identify documentation trends for outlier providers and facilitates education work plans to improve the quality, completeness, timeliness, and accuracy of medical record documentation for professional and hospital services.
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Creates and provides group education and training based on accurate coding practices, coding compliance documentation, and regulatory provisions. Codes medical records as needed based on organizational needs.
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Associates Degree in Healthcare related field, Medical Record Sciences, or Business/Healthcare Administration or four (4) years coding experience may be considered in lieu of education requirement.
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Ou client is seeking a dynamic and dedicated Permanent Inpatient Medical Coding Specialist to join our technology-driven healthcare team. Our client is looking to hire Inpatient Medical Coding Specialists.
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